Background The choroid contributes to optic nerve head perfusion, and its vascular dysfunction potentially contributes to glaucoma pathogenesis. Variations in blood flow and choroidal thickness (CT) can influence optic nerve vulnerability, highlighting the choroid’s importance in understanding glaucomatous damage. Aim To evaluate the effect of commonly used glaucoma medications on CT in patients with primary open-angle glaucoma using enhanced depth imaging optical coherence tomography (EDI-OCT). Patient and methods This cross-sectional, comparative, noninvasive study comprised 20 normal eyes and 60 eyes suffering of mild to moderate primary open-angle glaucoma who were under either monotherapy or combined therapy. Participants divided into four groups: Group I (included 20 normal eyes as control group), while Groups II, III, IV comprised glaucomatous eyes treated with (alpha-adrenergic agonists), (combined carbonic anhydrase inhibitors and β-blockers), and (prostaglandin analogues) respectively. CT was assessed at three locations: subfoveal (SFCT), 1 mm nasal, and 1 mm temporal to the fovea by Spectralis HRA-OCT in enhanced depth imaging (EDI) mode. Results Patients receiving combined carbonic anhydrase inhibitor and β-blocker therapy showed significantly decreased subfoveal and parafoveal CT compared with controls and other treatment groups. These findings suggest a more pronounced choroidal thinning effect with this combination. Conclusions Topical antiglaucoma therapy with CAIs and β-blockers may impact ocular perfusion, unlike prostaglandin analogues or alpha-adrenergic agonists. Clinicians should consider these vascular effects, particularly in patients with chorioretinal diseases or compromised ocular circulation when selecting long-term treatment options.
Elregal et al. (Wed,) studied this question.