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Purpose: The purpose of this study was to determine whether timolol drops compared to placebo drops had a significant effect on retinal vessel width in ocular hypertensives. Methods: Thirty-seven ocular hypertensives were randomly assigned to receive placebo or 0.5% timolol drops to both eyes for 18 to 24 months in a double masked clinical trial. Measurements of ocular pressure and retinal vessel width by computerized image analysis from fundus photographs were made at about 3 month intervals for 18 to 24 months of follow-up. Results: None of the subjects developed visual field loss when tested with the Goldmann perimeter by kinetic and static means at six month intervals. Subjects treated with the placebo showed no change in ocular pressure and a significant decrease in retinal vessel width over time especially in the right eye. Subjects treated with timolol had an increase in retinal vessel width compared to the placebo group significant especially for the superior temporal vein. Multivariate analyses indicated that the increase of retinal vessel width was not associated mainly with the ocular pressure on treatment or decrease in ocular pressure on treatment. Conclusion: Timolol treatment was associated with an increase of retinal vessel width. The effect of timolol appears to be related primarily to mechanisms other than the decrease in ocular pressure.

An objective method for reliably estimating the width of retinal vessels is presented. A computerized microdensitometer scans film negatives of fundus photographs and reconstructs black and white images of the fundus on a visual display terminal. After this initial scan, a desired region of a retinal vessel is selected with moveable cursors, and a cross-sectional density profile through the vessel is plotted. Vessel width is determined by the half-height width of the profile of the minimum (least transmitting) and average background film densities. Measurement sites can be accurately reproduced on different negatives by landmark mapping. A series of ten fundus photographs were taken of three healthy human eyes, and the width of the superior temporal vein was measured in two places on alle negatives. The coefficient of variation of the six sets ranged from 1.2 and 3.4% with an average of 2.2%.