The effects of moxaverine on ocular blood flow in patients with age-related macular degeneration or primary open angle glaucoma and in healthy control subjects

Purpose: The phosphodiesterase inhibitor moxaverine has been shown to increase choroidal blood flow (BF) in young healthy subjects. The present study was performed to investigate the effect of intravenously administered moxaverine on ocular BF in patients with age-related macular degeneration (AMD), primary open angle glaucoma (POAG) and in age-matched control subjects. Methods: Twenty patients with AMD, 20 patients with POAG and 20 control subjects were included. Moxaverine 150 mg was applied intravenously over 30 min. BF was measured in the choroid and in the optic nerve head (ONH) using laser-Doppler flowmetry and in retinal vessels combining laser-Doppler velocimetry with retinal vessel analysis before and 30, 60 and 90 min after start of drug administration. BF velocities in the retrobulbar vessels were measured using colour Doppler imaging. Results: Moxaverine increased choroidal BF by 9 ± 22% (p = 0.012), ONH BF by 13 ± 33% (p = 0.021), mean flow velocity in the ophthalmic artery by 23 ± 34% (p < 0.001) and in the posterior ciliary arteries by 25 ± 35% (p < 0.001). Moxaverine had no significant effect on retinal vessel diameters and retinal BF. There were no significant differences in any of the measured parameters between the three groups. Conclusion: The present study indicates that systemic administration of moxaverine increases choroidal and ONH BF in elderly patients with eye diseases associated with hypoperfusion and in age-matched controls. Further studies in patients are needed to investigate whether long-term treatment with moxaverine is clinically beneficial for patients with ocular diseases.