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1.
AIMS: To compare the diurnal intraocular pressure (IOP) efficacy and safety of timolol vs latanoprost in subjects with exfoliation glaucoma (XFG). METHODS: A 3-month prospective, single-masked, active-controlled, parallel comparison performed in six centres in Greece that randomized subjects in a 1 : 1 ratio to either latanoprost in the evening (2000 hours) and placebo in the morning (0800 hours), or timolol twice daily (0800 and 2000 hours). RESULTS: In all, 103 subjects completed the study. After 3 months of chronic dosing, the latanoprost group exhibited a trend to a greater diurnal IOP reduction from an untreated baseline (24.9+/-3.2-17.4+/-2.9) compared with timolol (24.7+/-2.8-18.3+/-1.9 mmHg) (P=0.07). Latanoprost showed a significantly greater IOP reduction at 0800 hours (-8.5 vs -6.0 mm Hg for timolol, P<0.0001) whereas no difference was observed between the two medications at 1000, 1400, and 2000 hours after a Bonferroni Correction. In addition, latanoprost demonstrated a narrower range of diurnal IOP (2.4) than timolol (3.2 mmHg)(P=0.0017). Safety was similar between groups, except there was more conjunctival hyperaemia with latanoprost (n=8) than timolol (n=1)(P=0.01). CONCLUSIONS: This study suggests that latanoprost provides a statistically lower 08:00-hour IOP and better range of IOP than timolol in the treatment of XFG glaucoma.  相似文献   

2.
目的探讨吲哚美辛对拉坦前列腺素治疗慢性闭角型青光眼降眼压效果的影响。方法60例患者随机分为两组:对照组30例,应用0.005%拉坦前列腺素眼液治疗,每晚20时滴眼1次,每次1滴,共用6周;试验组30例,应用拉坦前列腺的同时,自第3周起每日加用吲哚美辛25mgtid共用4周。分别于治疗前,治疗后2、4、6周行视力,视野、眼压,裂隙灯显微镜,房角镜及直接检眼镜等检查。眼压检查应用Goldmann压平眼压计由专人测量,测量时间为每日9时,每个时间点均测量3次,取平均值进行统计学分析。结果共57例(试验组29例,对照组28例)顺利完成随访。试验组和对照组患者的眼压在治疗后2、4、6周分别比治疗前下降了22.1%和18.6%、32.0%和15.4%、33.6%和16.6%。两组间眼压比较,治疗后2周比较差异无统计学意义(t=0.62,P>0.05),而治疗后4、6周差异有高度统计学意义(t=5.41,6.98,P<0.01)。试验组各时间点之间进行方差分析,治疗后2周和治疗后4、6周之间差异有统计学意义(p=0.006,0.001),而对照组各时间点之间进行方差分析,治疗后2、4、6周之间差异无统计学意义(P=0.392、0.585、0.757)。结论拉坦前列腺素联合吲哚美辛治疗慢性闭角型青光的降眼压效果优于单纯应用拉坦前裂腺素,并且无特殊不良反应。  相似文献   

3.
AIMS: To evaluate efficacy and safety in patients with ocular hypertension or open angle glaucoma changed to latanoprost/timolol fixed combination (LTFC). METHODS: A prospective, multicentre, historical control in which qualified patients had their previous therapy substituted by LTFC and were followed for at least 2 months. RESULTS: In 1676 patients LTFC was continued in 93% throughout the observation period. In all patients LTFC reduced the intraocular pressure (IOP) from 20.6 (SD 3.8) to 17.7 (3.0) mm Hg (p<0.001) compared to previous monotherapies including latanoprost, timolol, alpha agonists or carbonic anhydrase inhibitors (CAI). LTFC provided more efficacy after changing from adjunctive therapies including: a beta blocker added to either CAI, alpha agonist, or pilocarpine, or CAI added to an alpha agonist, or latanoprost added to either CAI, alpha agonist, or beta blocker (unfixed combination), and travoprost added to timolol (p<0.007). LTFC was as effective as latanoprost used with dorzolamide/timolol fixed combination (-0.9 mm Hg, p = 0.1792). The most common reason to discontinue therapy was lack of efficacy (n = 70, 4%) and adverse event (n = 17, 1%). CONCLUSION: In a clinical setting, patients who have their monotherapy or adjunctive therapy substituted with LTFC may experience reduced IOP, good tolerability, and continuation of therapy for the first 2-3 months of treatment.  相似文献   

4.
Liu CJ  Ko YC  Cheng CY  Chiu AW  Chou JC  Hsu WM  Liu JH 《Ophthalmology》2002,109(12):741-2247
OBJECTIVE: To evaluate and compare the effects of latanoprost 0.005% once daily and brimonidine tartrate 0.2% twice daily in patients with normal-tension glaucoma (NTG). DESIGN: A randomized, open-label, crossover study. PARTICIPANTS: Twenty-eight NTG patients with progressive visual field defects/optic disc excavation, new disc hemorrhage, or field defects that threatened fixation. INTERVENTION: Patients were randomly allocated to one of two groups. Patients in group 1 were treated with latanoprost, lubricant, and brimonidine for 4 weeks each, whereas patients in group 2 were treated with brimonidine, lubricant, and latanoprost for 4 weeks each. MAIN OUTCOME MEASURES: Intraocular pressure (IOP), pulse rate, and blood pressure were measured at 8 am, 12 noon, and 4 pm after each 4-week treatment. Ocular perfusion pressure (OPP) was calculated. RESULTS: Latanoprost and brimonidine reduced the average IOP by 3.6 +/- 1.9 mmHg (P < 0.001) and 2.5 +/- 1.3 mmHg (P < 0.001), respectively, with a significant difference between the two regimens (P = 0.009). Both drugs significantly reduced IOP at each time point. Latanoprost decreased IOP significantly more than did brimonidine at 8 am (11.7 +/- 2.2 mmHg vs. 13.7 +/- 2.1 mmHg, P = 0.004) and 4 pm (11.4 +/- 2.1 mmHg vs. 13.2 +/- 2.9 mmHg, P = 0.004), but IOP was equal between the two agents at 12 noon (11.5 +/- 2.6 mmHg vs. 11.5 +/- 2.3 mmHg, P = 0.967). IOP was maintained at 12 mmHg or lower in 18 (66.7%) of 27 patients after treatment with latanoprost and in 9 (33.3%) of 27 patients after treatment with brimonidine. Latanoprost monotherapy reduced IOP by 30% in 8 patients (29.6%), but brimonidine monotherapy did not reduce IOP by that much in any of the patients. OPP increased after latanoprost treatment (P < 0.001) but did not increase after brimonidine treatment (P = 0.355). There was no significant change in pulse rate or blood pressure. CONCLUSIONS: Both latanoprost and brimonidine reduce IOP in NTG patients. Brimonidine has a peak IOP-lowering effect equal to that of latanoprost but produces a higher mean diurnal IOP than does latanoprost because of its shorter effect. Latanoprost might favorably alter optic disc blood perfusion by increasing OPP.  相似文献   

5.
The purpose of this study was to evaluate the success rate ofmonotherapy with latanoprost 0.005% once daily versus brimonidine 0.2% twice daily in patients with open-angle glaucoma or ocular hypertension. Patients who were prescribed latanoprost or brimonidine as monotherapy were included in this study, and their consecutive charts were retrospectively reviewed. The primary efficacy variable was success of therapy, defined as a reduction in intraocular pressure > or =3 mm Hg without an adverse event leading to discontinuation over a potential of six months of therapy. We included 157 patients in this study. In the latanoprost group, 64 of 92 (70%) were considered successes; 26 of 65 (40%) were successful with brimonidine (P < 0.001). Nine failed brimonidine therapy, and one latanoprost, because of an adverse event, and the rest failed because of inadequate intraocular pressure response. The change from baseline in intraocular pressure was significantly greater with latanoprost (mean +/- S.D., 21.6 +/- 5.1 to 17.1 +/- 3.3 mm Hg) than brimonidine (23.7 +/- 5.6 to 21.9 +/- 5.7 mm Hg) (P = 0.001). Overall, 52 (80%) brimonidine- and 41 (45%) latanoprost-treated patients required additional visit(s) to adjust therapy to further lower intraocular pressure or to assess an adverse event (P < 0.001). In conclusion, latanoprost more likely provides a successful response to therapy than brimonidine when used as monotherapy in primary open-angle glaucoma or ocular hypertensive patients.  相似文献   

6.
This is a case series of 3 patients who presented with periocular changes in the treated eye following chronic administration of unilateral latanoprost 0.005%. The clinical changes included worsening of dermatochalasis, deepening of superior sulcus and hollowness of the lid. This similar observation was previously described in usage of bimatoprost 0.03% and travoprost 0.004%. However this has not been reported in latanoprost instillation. Therefore, patients should be made aware of these potential side effects.  相似文献   

7.
PURPOSE: To evaluate the effect of substituting latanoprost(LAT) 0.005% for unoprostone(UNO) 0.12% after a trial of unilateral treatment. METHODS: We treated 30 patients with primary open-angle glaucoma(n = 8), ocular hypertension (n = 1), or normal-tension glaucoma(n = 21) with UNO for 4 weeks in one eye and then substituted LAT for UNO. Four weeks later we measured the intraocular pressure(IOP) in the ipsilateral eye. RESULTS: The mean baseline IOP level was 18.6 +/- 3.8(mean +/- standard deviation) mmHg. The mean IOP levels(reduction rates) after UNO and LAT therapy were 16.7 +/- 3.1 mmHg (16.6%) and 14.1 +/- 3.2 mmHg (28.9%), respectively(p < 0.001). All patients who responded to UNO also responded to LAT; however, 55% of those who did not respond to UNO responded to LAT. CONCLUSIONS: If LAT is substituted for UNO, it can be predicted that 63.3% of the patients will respond.  相似文献   

8.
AIM: To determine the effect of brimonidine tartrate 0.2% and latanoprost 0.005% on pulsatile ocular blood flow (POBF) in patients with normal tension glaucoma (NTG). METHOD: NTG patients with progressive optic neuropathy, new disc haemorrhage, or field defects that threatened fixation were enrolled into a randomised, investigator masked, crossover study. Group I patients received 4 weeks each of latanoprost, lubricant, and brimonidine, while group II patients received 4 weeks each of brimonidine, lubricant, and latanoprost. Diurnal POBF was measured at baseline and after each 4 week treatment. RESULTS: 25 patients completed the study and had reliable POBF measurement at each visit. There was no significant diurnal change in baseline POBF (p = 0.768). Latanoprost increased POBF by 213 (SD 257) micro l/min (22.8%, p <0.001) while brimonidine increased it by 97 (183) micro l/min (10.4%, p = 0.014). POBF increased at 8 am (p = 0.004), 12 noon (p = 0.002), and 4 pm (p <0.001) with latanoprost, while it increased only at 8 am (p = 0.016) with brimonidine. After adjusting for the factor of IOP, neither latanoprost nor brimonidine increased POBF significantly. CONCLUSIONS: Latanoprost increases the mean POBF that is related to its IOP lowering effect. The increase in POBF noted after brimonidine is within the range of long term variation and may not be attributable to the drug effect.  相似文献   

9.
Background. Latanoprost, a prostaglandin F-analogue, has been widely in use in clinical practice for a period of over 5 years. The side-effects of latanoprost are analyzed and the clinical relevance is discussed. Results. Hypertrichosis and increased pigmentation of eyelashes will develop in the majority of patients using latanoprost for more than 6 months. Increased pigmentation of the eyelids may also occur. Hyperpigmentation of the iris is seen in 12–18% of caucasians using latanoprost over a period of 1–2 years. Increased iris pigmentation seems more common in asian people and remains unchanged after discontinuation of therapy. Pigmentation of intra- and extraocular structures is caused by increased melanogenesis, not by melanocyte proliferation. Mild conjunctival hyperemia may develop in approximately 30% of patients, but is most often without clinical relevance. Further reported side-effects include anterior uveitis, reactivation of herpes-keratitis/-dermatitis and cystoid macular edema in pseudophakic and aphakic patients. A causal relationship has still not been proven for these side-effects. Systemic side-effects are rare (e.g. headache, facial rash, cardiovascular effects). No experience exists for treatment of glaucoma with latanoprost in childhood. Conclusion. Latanoprost represents a highly effective antiglaucomatous drug, rarely associated with vision-threatening complications. The most common complications are hypertrichosis of eyelashes and increased pigmentation of extra- and intraocular structures. A careful lifetime evaluation of these patients is recommended. Systemic side-effects are rare, but may occur.  相似文献   

10.
PURPOSE: To evaluate the efficacy and safety of latanoprost 0.005% given topically every evening versus brimonidine 0.2% given topically twice daily in primary open-angle glaucoma or ocular hypertensive patients. METHODS: This was a multicenter, crossover, double-masked comparison. After a 28-day treatment-free period, patients with primary open-angle glaucoma or ocular hypertension were randomized for 6 weeks to brimonidine or latanoprost and then crossed over to the opposite treatment. At baseline and after each treatment period, patients underwent intraocular pressure measurements every 2 hours from 08:00 to 20:00. RESULTS: In 33 patients the mean baseline trough (08:00) was 23.2 +/- 2.1 mm Hg and the diurnal curve pressure was 19.8 +/- 2.7 mm Hg. The trough and diurnal intraocular pressures for brimonidine were 19.6 +/- 3.4 mm Hg and 17.6 +/- 2.2 mm Hg, respectively. Brimonidine statistically reduced the pressure from baseline at each time point except hours 10 and 12 (P =.14 and P =.21, respectively). For latanoprost, the trough and diurnal pressures were 16.2 +/- 2.9 mm Hg and 15.4 +/- 2.5 mm Hg, respectively, and the pressure was statistically reduced at each time point (P <.001) and for the diurnal curve (P <.001). When compared directly, the intraocular pressure level for latanoprost was lower than brimonidine for the diurnal pressure and at each time point (P <.05). One patient was discontinued early from latanoprost treatment because of eyelid swelling; also, latanoprost caused more hyperemia than brimonidine (P =.04). CONCLUSION: This study suggests latanoprost dosed daily in the evening statistically reduces intraocular pressure more during daytime and evening hours than brimonidine dosed twice daily. Brimonidine may not consistently decrease the pressure 10 and 12 hours past dosing from nontreated levels.  相似文献   

11.
12.
PURPOSE: To evaluate the safety and efficacy of adding unoprostone isopropyl 0.12% vs placebo both given twice daily to latanoprost 0.005% given every evening. METHODS: We treated 41 patients with primary open-angle glaucoma or ocular hypertension with latanoprost 0.005% for 1 month and then randomized each to either placebo or unoprostone isopropyl 0.12% for 8 weeks. Diurnal intraocular pressures were measured at 08:00, 10:00, 12:00, 18:00, and 20:00 hours, both at baseline (time of randomization) and after 8 weeks of treatment. RESULTS: Twenty patients were treated in the placebo group and 21 in the unoprostone isopropyl group. After 8 weeks of treatment in the placebo group, the trough intraocular pressure at 08:00 and the diurnal pressure were 20.4 +/- 3.2 and 19.1 +/- 2.2 mm Hg, respectively. In the unoprostone isopropyl group the pressures were 19.4 +/- 3.3 and 18.0 +/- 1.7 mm Hg (P =.22 and P =.042), respectively. However, eyes with a baseline pressure of 22 mm Hg or greater on latanoprost had an average 3.3 mm Hg greater reduction at trough (P <.01) and a 2.1 mm Hg greater decrease in diurnal pressure (P =.030) after adding unoprostone isopropyl (n = 14 eyes) compared with placebo (n = 16 eyes; P <.001). In addition, the range of the pressures throughout the diurnal curve was reduced from 2.7 mm Hg on latanoprost alone to 1.4 mm Hg after adding unoprostone isopropyl. Adverse events were similar between groups, and no patients were discontinued because of safety reasons. CONCLUSIONS: This study suggests that unoprostone isopropyl can safely improve the diurnal curve characteristics in patients who continue to have an elevated pressure on latanoprost 0.005% alone.  相似文献   

13.
14.
15.
PURPOSE: To compare the intraocular pressure)-lowering effect and side effects of latanoprost 0.005% once daily with unoprostone 0.12% twice daily. METHODS: Sixty patients with primary open-angle glaucoma or ocular hypertension were randomized to receive either latanoprost once daily in the evening and placebo once daily in the morning, or unoprostone twice daily in the morning and evening. The study was double masked and followed a crossover design with two treatment periods of 1 month separated by a 3-week washout period. The intraocular pressure was measured at 9 AM and 5 PM on the baseline and day 28 visits, and at 9 AM on day 2 and day 14 visits of each treatment period. The 9 AM measurement was taken 2 hours and 13 hours after the last drop of unoprostone and latanoprost, and the 5 PM measurement was at 10 and 21 hours, respectively. The mean of the measurements was calculated. Safety parameters were also recorded. RESULTS: Fifty-six patients completed both treatment periods and had intraocular pressure data available for evaluation. After 1 month of treatment, latanoprost significantly reduced intraocular pressure (mean +/- SEM) by 6.1 +/- 0.5 mm Hg (P <.001) and unoprostone by 4.2 +/- 0.4 mm Hg (P <.001) adjusted from an overall baseline of 22.3 +/- 0.5 mm Hg and 23.2 +/- 0.4 mm Hg, respectively. The difference of 1.9 mm Hg between treatments was statistically significant in favor of latanoprost [P =.003, analysis of covariance (ANCOVA)]. Unadjusted analysis of responders using the percentage decrease in intraocular pressure showed that the proportion of responders in the latanoprost-treated group was greater than in the unoprostone-treated group. Adverse ocular symptoms and findings were mild in both treatment groups. Eye redness and ocular irritation were the most frequently reported events. CONCLUSIONS: Latanoprost once daily was significantly more effective in reducing intraocular pressure compared with unoprostone twice daily after 1 month of treatment in patients with primary open-angle glaucoma and ocular hypertension. Both drugs were well tolerated with few ocular adverse events.  相似文献   

16.
PURPOSE: To evaluate the short-term additive effects of latanoprost 0.005% and brimonidine 0.2%. METHODS: This study was a randomized, double-masked, cross-over study that included 32 patients (32 eyes) with primary open-angle glaucoma or exfoliation glaucoma. On baseline day, intraocular pressure (IOP) was measured at 10 AM and 11 PM. Baseline IOP values were obtained by calculating the mean values for both eyes. After this process, latanoprost 0.005% was prescribed once a day during the first 5 days at 10 PM as the first test drug. During the second 5 days, twice a day brimonidine 0.2% or a placebo, as the second test drug, was added to the latanoprost at 9 AM and 10 PM. After a 4-week washout period, latanoprost 0.005% was prescribed once a day during the first 5 days at 10 PM and during the second 5 days, the second test drug, brimonidine or a placebo, was added to latanoprost, and the two drugs were prescribed twice a day for 5 days. RESULTS: During the second 5 days, although an additional 2.53-3.10 mm Hg decrease in IOP was determined in the latanoprost+brimonidine group, there was no additional decrease in the latanoprost+placebo group. CONCLUSIONS: This study showed that brimonidine and latanoprost have an additive IOP-lowering effect in open-angle glaucoma patients in the short term.  相似文献   

17.

Purpose  

To compare the intraocular pressure (IOP) reduction over 24 h achieved with tafluprost (0.0015%) with that achieved with latanoprost (0.005%).  相似文献   

18.
PURPOSE: To evaluate the use of latanoprost 0.005% given once daily to simplify a patient's glaucoma medical regimen. METHODS: We reviewed 527 charts of which we included 61 patients (61 eyes) with either ocular hypertension or primary open-angle glaucoma who were prescribed latanoprost for the purpose of simplifying their glaucoma medical regimen. The successful substitution of latanoprost was defined as a reduction in the number of dosages given daily with the maintenance of intraocular pressure for at least three months no higher than 2 mmHg from the previous medical regimen. RESULTS: This study showed that 43 of 61 patients (70.4%) had latanoprost substituted allowing for fewer dosages per day. Following the substitution the intraocular pressure in the success group fell from 22.5+/-5.9 mmHg to 18.3+/-3.8 mmHg (p<0.001) over an average follow-up of 6.6+/-1.9 months. The total number of dosages per day in the success group fell from 4.8+/-2.4 to 1.7+/-1.3 at exit (p<0.001). Twenty-two patients had one medicine, 14 patients two, and seven patients three medicines discontinued after latanoprost was added. Reasons for failure after the substitution were ineffectiveness of latanoprost (n=11) or an adverse event (n=7). No trends in the number or types of medicines at baseline discontinued were observed in the success or failure groups. CONCLUSION: This study shows that latanoprost 0.005% once daily can be substituted for one or more medicines in the majority of ocular hypertension and primary open-angle glaucoma patients to simplify the medical regimen.  相似文献   

19.
Abstract Purpose: To compare the intraocular pressure (IOP)-lowering effect of 0.005% latanoprost used once every other day versus once daily in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT). Methods: Forty eyes of 20 patients with bilateral OHT or early POAG were enrolled in this prospective, randomized, crossover study. After a washout period of 1-4 weeks, each patient started latanoprost once daily in 1 randomly assigned eye and once every other day in the other eye. After 1 month, eyes were crossed over to the opposite dosing regimen for another month. IOP was measured at 9 am, 4 pm, and 9 pm, both at baseline and on 2 consecutive days, at the end of the first and second months. The main outcome measure was IOP reduction on the second day at the end of the first and second months. Results: Mean±standard deviation (SD) baseline IOPs (mmHg) in the right and left eye were 25.6±2.6 and 25.5±2.7 (P=0.8), respectively. Mean±SD diurnal IOPs decreased (mmHg) by 8.6±2.5 in the once-daily group versus 7.3±2.3 in the every-other-day group (P<0.001) at the end of the first month and 8.4±2.5 versus 7.7±2.5 at the end of the second month (both on day 2) (P=0.01). Conclusions: Once every-other-day administration of latanoprost significantly reduced the IOP although the IOP reduction was less pronounced 36-48?h after drug application.  相似文献   

20.
AIM: To evaluate the therapeutic efficacy, safety and tolerability of newly developed preservative-free (PF) latanoprost generic [TJO-002] and compare it with benzalkonium chloride (BAK)-preserved latanoprost [Xalatan®] in patients with primary open angle glaucoma (POAG) and ocular hypertension (OHT). METHODS: Included patients were aged ≥19y with POAG/OHT. After a washout period, patients with IOP 21-35 mm Hg at 9 a.m. were enrolled. After a full ophthalmic and glaucoma examination, 144 patients with POAG and OHT participated in this study. Subjects were randomly assigned either PF latanoprost (74 eyes) or BAK-preserved latanoprost (70 eyes). All subjects were examined at 4, 8, and 12wk after first administration. At each follow-up visit, IOP was measured at 9 a.m. and 5 p.m. and compliance was assessed. Throughout the study, all adverse events were recorded and monitored by the masked investigators who measured IOP. RESULTS: Both groups showed a statistically significant decrease of average diurnal IOP at 12wk compared to baseline (-7.21±3.10 mm Hg in the PF latanoprost group and -7.02±3.17 mm Hg in the BAK latanoprost group, both P<0.0001). There was no statistically significant diurnal IOP variation between the groups. In terms of tolerability, pruritus, burning/stinging, and sticky eye sensation, severity was significantly lower in the PF latanoprost group than in the BAK latanoprost group (P<0.05). CONCLUSION: PF latanoprost has at least similar efficacy in terms of IOP reduction and better tolerability compared with BAK latanoprost.  相似文献   

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