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To investigate the effect of timolol-dorzolamide and timolol-pilocarpine fixed combinations on retrobulbar vessel blood flow.Prospective, randomized, masked, crossover clinical trial.Sixteen patients with primary open angle glaucoma, treated with timolol 0.5%, received timolol 0.5%-dorzolamide 2% and timolol 0.5%-pilocarpine 2% for four weeks each. Heart rate, blood pressure, intraocular pressure (IOP), and peak systolic (PSV) and end diastolic velocities (EDV) in ophthalmic, central retinal, and short posterior ciliary arteries were measured before and after each treatment, and resistivity index was calculated.The IOP was reduced (P.01) by timolol-dorzolamide and, more effectively, timolol-pilocarpine combinations. In central retinal artery, the end diastolic velocity was increased by the timolol-dorzolamide combination (P.01), resulting in higher end diastolic velocity and lower resistivity index values (both P.01) compared with the timolol-pilocarpine combination.The timolol-dorzolamide combination increases the end diastolic velocity in central retinal artery, despite a lower intraocular pressure decrease, suggesting an effect on retinal circulation.

Purpose To determine the choroidal thickness in the macular area in patients with idiopathic macular hole in one eye and an unaffected fellow eye and in healthy controls. Design Cross-sectional, prospective study. Methods Twenty-two patients with a full-thickness unilateral idiopathic macular hole and 22 age- and sex-matched controls were recruited. Enhanced depth imaging optical coherence tomography images were obtained by using spectral-domain optical coherence tomography. The choroidal thickness was measured in the subfoveal area and 1000 μm and 2000 μm away from the fovea in the nasal and temporal regions. The diameter of the macular hole and the axial length were determined. Results Choroidal thickness was significantly different across the 3 groups at all locations (P < .001, analysis of variance). The choroid was significantly thinner in eyes with idiopathic macular hole and in unaffected fellow eyes than in the control group (P < .01, Tukey-Kramer test). The mean subfoveal choroidal thickness was 183.2 μm in the idiopathic macular hole group, 196.6 μm in the fellow-eye group, and 245.0 μm in the control group. A negative correlation between subfoveal choroidal thickness and axial length was found in all groups (macular hole, r = -0.53, P = .01; fellow eyes, r = -0.56, P < .01; controls, r = -0.52, P = .01); in control eyes, a negative correlation was found between choroidal thickness and age (r = -0.48, P = .02). Conclusions Choroidal thickness was reduced in eyes with idiopathic macular hole and also in fellow unaffected eyes. This may suggest a contributing role of the choroid in the pathogenesis of idiopathic macular hole.

To evaluate the efficacy of low-fluence compared with standard-fluence rate photodynamic therapy (PDT) for treating chronic central serous chorioretinopathy.Prospective, multicenter, investigator-masked, nonrandomized clinical trial.Forty-two eyes (42 patients) with chronic central serous chorioretinopathy were enrolled; 19 eyes received indocyanine green angiography-guided standard-fluence PDT (50 J/cm(2)) and 23 eyes received indocyanine green angiography-guided low-fluence PDT (25 J/cm(2)). Primary outcome measures were the changes in mean logarithm of the minimal angle of resolution best-corrected visual acuity and the rate of eyes with complete subretinal fluid reabsorption. Secondary outcomes were the changes in central foveal thickness and choroidal perfusion.Mean logarithm of the minimal angle of resolution best-corrected visual acuity improved significantly at all time points (P.01), in the standard-fluence group from 0.43 to 0.24 at 12 months and in the low-fluence-group from 0.46 to 0.16, without significant difference between the 2 groups. At 12 months, a complete subretinal fluid reabsorption was seen in 15 standard-fluence-treated and 21 low-fluence-treated eyes (79% vs 91%; P = .5). In 1 standard-fluence eye, choroidal neovascularization developed at 3 months, and this eye received further PDT; in the other eyes, at 12 months, a moderate-significant choriocapillaris nonperfusion was seen in 8 standard-fluence-treated and 0 low-fluence-treated eyes (44% vs 0%; P = .002).In most of the eyes, both standard-fluence PDT and low-fluence PDT resulted in complete subretinal fluid reabsorption with visual acuity improvement. Choroidal hypoperfusion related to PDT could be reduced by low-fluence PDT.

To evaluate the effect of low-fluence photodynamic therapy (PDT) on central retinal sensitivity and fixation stability as compared with standard-fluence PDT for treating chronic central serous chorioretinopathy (CSC).Prospective longitudinal follow-up of patients enrolled in a nonrandomized clinical trial of standard-fluence vs low-fluence PDT in chronic CSC.Forty-two eyes (42 patients) with chronic CSC were enrolled; 19 eyes received indocyanine green angiography-guided standard-fluence PDT (50 J/cm(2)) and 23 received indocyanine green angiography-guided low-fluence PDT (25 J/cm(2)). Retinal sensitivity in the central 12 degrees and fixation stability were evaluated by MP-1 microperimeter at baseline and at 3 and 12 months after PDT.Mean central retinal sensitivity improved significantly at all time points (at 12 months vs baseline P.01, Tukey-Kramer test), in the standard-fluence group from 11.9 to 14.4 at 12 months, and in the low-fluence-group from 11.8 to 16.3, with a significant difference between the 2 groups (P = .04, t test). Fixation stability did not change in either group (not significant, analysis of variance). At 12 months' follow-up the retinal sensitivity significantly correlated with best-corrected visual acuity in both groups (standard-fluence, r = -0.52, P = .02; low-fluence, r = -0.54, P = .01).The study shows a significant improvement in macular sensitivity after PDT in eyes with chronic CSC, with greater efficacy in low-fluence-treated eyes. Microperimetry data suggest that low-fluence PDT may be a good treatment option in patients with chronic CSC.