Beta-blocker eyedrop and nocturnal arterial hypotenion Original Reearch Article

PURPOE: To invetigate the effect of topical beta-blocker eyedrop on nocturnal arterial hypotenion and heart rate and on viual field deterioration. METHOD: We propectively invetigated 275 white patient, 161 with glaucomatou optic neuropathy and 114 with nonarteritic anterior ichemic optic neuropathy, by 24-hour ambulatory blood preure monitoring and diurnal curve of intraocular preure, in addition to detailed ophthalmic evaluation. Of the patient with glaucomatou optic neuropathy, 131 had normal-tenion glaucoma and 30 had primary open-angle glaucoma. Of the 275 patient, 114 were uing topical beta-blocker eyedrop twice daily (76 with normal-tenion glaucoma, 26 with primary open-angle glaucoma, and 12 with anterior ichemic optic neuropathy). REULT: Hourly average blood preure data analye howed overall a drop in blood preure a well a heart rate during leep, and a ignificantly greater drop in mean diatolic blood preure (P = .009) at night in normal-tenion glaucoma than in anterior ichemic optic neuropathy. Alo, patient uing beta-blocker eyedrop experienced a ignificantly greater percentage drop in diatolic blood preure at night (P = .028), lower minimum nighttime diatolic blood preure (P = .072), and lower minimum nighttime heart rate (P = .002) than did thoe not uing them. In normal-tenion glaucoma, eye receiving beta-blocker eyedrop howed viual field progreion ignificantly (P = .0003) more often than thoe not receiving beta-blocker. CONCLUION: The finding of our tudie, a well a thoe of other, ugget that any factor that increae nocturnal arterial hypotenion i a potential rik factor in vulnerable individual with glaucomatou optic neuropathy or anterior ichemic optic neuropathy. The preent tudy ugget that the ue of beta-blocker eyedrop, by aggravating nocturnal arterial hypotenion and reducing the heart rate, may be a potential rik factor in uceptible individual.