Glaucoma: Diagnosis and Therapy

Re: The change of ocular blood flow after topical.. by Emi K, et al.

On Tue Dec 15, Jost B Jonas wrote
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>Deart Dr. Emi,
>congratulations for your interesting study. May I ask you:
>1) Did unoprostone decrease the IOP ?
>2) If yes, is it theoretically possible that the increased blood velocity measurements were due to the reduced IOP and were not directly and specifically caused by unoprostone itself ?
>3) How representative are blood velocity measurements for the assessment of bood flow, for example in the case of a stenosis ?
>4) What is the reproducibility of the method in your laboratory ?
>5) Did you have a control group taking a placebo ?
>Yours sincerely
>Jost Jonas

Reply to Dr. Jonas

Answer for 1: Yes, really unoprostone decreased the IOP in normal subjects.
Answer for 2: I guess you want to say the increment of the blood flow velocity only depends on the pressure gradient between the systemic blood pressure and intraocular pressure. I can't deny your opinion, but no significant change of the pulsatility index and previous data in animals may partly suggest that unoprostone have no vasoconstrictive effect or slight favorable effect on the ocular blood circulation.
Answer for 3: I think a significant vasoconstriction or stenosis causes the decrease in end-diastolic velocity and increase in pulsatility index.
Answer for 4: In my laboratoly the reproducibility varies between 5% to 12% depends on the parameters.
Answer for 5: I do not have the control group. As you said, the contorolled larger study is needed for definite conclusion.

Tank you for interesting question!

Kazuo Emi MD

Tue Dec 15