The Effects of α-adrenergic Receptor Antagonists on Choroid and Pupil

Study Overview
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Brief Summary
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It was aimed to evaluate and investigate the effects of tamsulosin hydrochloride, has preferential selectivity for the α1A receptor in the prostat versus the α1B receptor in the blood vessels, and alfuzosin hydrochloride on choroidal thickness (CT), pupil diameter sizes evaluated by using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) and scheimpflug/placido photography-based topoghraphy system in this study. 63 men patients with newly diagnosis of benign prostatic hyperplasia were randomly assigned to either alfuzosin hydrochloride or to tamsulosin hydrochloride groups in this prospective, randomized, parallel-group clinical trial. Enhanced depth imaging spectral-domain optical coherence tomography, pupillography were obtained at baseline, 1st and 3rd month, and choroidal thicknesses and pupil diameter sizes were compared between the 2 groups.

Detailed Description
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The local authorized clinical trials ethics committee approved the study and this study was performed following the principles of the Declaration of Helsinki. Detailed information was given to patients about clinical applications and tests, and signed informed consent forms were also obtained from all patients. 32 right eyes of 32 men with diagnosis of BPH initiated on AH (Xatral®) (10 mg/day) and 31 right eyes of 31 men with diagnosis of BPH initiated on TH (Flomax®) (0.4 mg/day) were included in this self-controlled prospective clinical trial. Urologists in the urology clinic made diagnosis of BPH, and 63 men diagnosis of BPH were directed towards eye clinic. AH or TH treatments were randomly recommended for previously untreated patients with newly diagnosis of BPH by urologists. After providing information to patients about the disease and treatment, patients predicted to show adherence to treatment, were enrolled in the study. Ophthalmological examinations were performed in all cases. Choroidal thicknesses (CTs) were measured under the fovea, 3 mm nasal to the fovea and 3 mm temporal to the fovea, and they were recorded as submacular (SCT), nasal (NCT) and temporal (TCT) choroidal thicknesses. CTs were measured and recorded by using EDI-OCT imaging (Cirrus HD 4000, Carl Zeis Meditec, CA, USA). Mesopic, scotopic and photopic pupil diameter sizes were measured and recorded by using Scheimpflug/Placido photography-based topography system in the pupillometer mode (Sirius, Italy). CTs, scotopic, mesopic and photopic pupil diameter sizes were measured and recorded at baseline, 1st and 3rd months. Data obtained from cases were encoded and they were transferred to the computer program. SPSS 20.0 software (SPSS Inc., Chicago, IL, USA) was used for statistical evaluation. Data distribution was tested using Kolmogorov-Smirnov test. Baseline values and 1st, 3rd month values were compared by using the repeated measure of ANOVA in intra-group evaluation and independent samples t-test in inter-group evaluation, and the significance level of p-value was accepted as 0,05 (P ≤ 0, 05). Progressions were evaluated by using repeated measures analyses of variance-ANOVA (with the Bonferroni correction) and the correlation between parameters were evaluated by using bivariate (Pearson's) correlation analysis. Positive values and negative values were considered to be correlated in the same direction and opposite direction, respectively in correlation analysis. Correlation coefficient values r ≥ |± 0.3| were accepted as correlation; and the significance level of P value that was below 0,05 was evaluated as the significant correlation.

Official Title
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The Effects of Systemic Alfuzosin and Tamsulosin Hydrochloride on Choroidal Thickness and Pupil Diameter Sizes in Cases With Benign Prostatic Hyperplasia

Conditions
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Benign Prostatic Hyperplasia, Pupil Anomaly, Choroid Disease

Intervention / Treatment
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* Drug: Alfuzosin Hydrochloride 10 MG
* Drug: Tamsulosin Hydrochloride 0.4 MG


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Best corrected visual acuity (BCVA) ≥ 0.8 Diagnosis of BPH and initiation of alfuzosin hydrochloride or tamsulosin hydrochloride treatments 45 years of age or older man Exclusion Criteria: Occluded angle by gonioscopy (grade 0, narrow angle, grade I, grade II) Corneal scarring or cataract that prevents appearance of the fundus Formation of macular or peripheral retinal pathologies or choroidopathy Optic nerve pathologies such as optic neuropathy Spherical refractive error ≥ ±6.00 D or cylinder refractive error ≥ ±3.00 D Systemic diseases that may affect choroidal blood flow

Ages Eligible for Study
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Minimum Age: 45 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: prospective, randomized, parallel-group clinical trial
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Alfuzosin Hydrochloride<br>Alfuzosin hydrochloride 10 mg tablet by mouth, every 24 hours for 3 months | Drug: Alfuzosin Hydrochloride 10 MG<br>* Alfuzosin hydrochloride Tablet<br>* Other names: Xatral;|
| Active Comparator: Tamsulosin Hydrochloride<br>Tamsulosin hydrochloride 0.4 mg tablet by mouth, every 24 hours for 3 months | Drug: Tamsulosin Hydrochloride 0.4 MG<br>* Tamsulosin Hydrochloride Tablet<br>* Other names: Flomax;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline choroidal thicknesses at 3 months | Choroidal thicknesses (CTs) measurement under the fovea, 3 mm nasal to the fovea and 3 mm temporal to the fovea at baseline, 1st and 3rd month, and recording as submacular (SCT), nasal (NCT) and temporal (TCT) choroidal thicknesses. | 1 month and 2 months | 
| Change from baseline pupil diameter sizes at 3 months | Mesopic, scotopic and photopic pupil diameter sizes measurement at baseline, 1st and 3rd months | 1 month and 2 months |