国产拉坦前列腺素治疗开角型青光眼和高眼压症的疗效及安全性

目的:观察国产拉坦前列腺素滴眼液(见康)治疗开角型青光眼和高眼压症的临床疗效及安全性。方法:采用随机、单盲对照研究。原发性开角型青光眼或高眼压症的患者90例随机分三组,试验组:国产0.05g/L拉坦前列腺素(见康);对照组1:进口0.05g/L拉坦前列腺素(适利达);对照组2:0.04g/L曲伏前列素(苏为坦),每组30例患者。三组患者均9:00pm给药1次,疗程4wk。结果:用药2wk后,三组间治疗后眼压差异无统计学意义(P=0.673)。治疗4wk后,三组日眼压曲线各时间点眼压下降值差异无统计学意义。三组病例中均有轻度结膜充血的患者,试验组4例(13%),对照组1:3例(10%),对照组2:8例(27%)。结论:国产拉坦前列素滴眼液(见康)可有效降低眼压,安全性好,为治疗开角型青光眼及高眼压症提供了新的选择。     

O.03%贝美前列素滴眼液与0.005%拉坦前列素滴眼液的降眼压效果和安全性比较

目的比较0.03%贝美前列素滴眼液与0.005%拉坦前列素滴眼液降眼压治疗的有效性和安全性.方法随机、研究者设盲、平行对照临床试验.56例原发性开角型青光眼或高眼压症患者,随机分配接受0.03%贝美前列素和0.005%拉坦前列素治疗,观察治疗42天后降眼压效果及不良反应.结果 0.03%贝美前列素和0.005%拉坦前列素均能显著降低眼内压(P＜0.001).6周治疗后,贝美前列素和拉坦前列素降低眼压分别为5.92～9.18mmHg(26.3%～36.1%)和7.25～9.85mmHg(31.3%～38.9%),两者之间差异无统计学意义.贝美前列素和拉坦前列素均有较好的安全性,最常见的不良反应为结膜充血.结论 0.03%贝美前列素滴眼液和0.005%拉坦前列素滴眼液均能显著降低国人开角型青光眼和高眼压症患者的眼压,而且安全、有较好的耐受性.两者差异无统计学意义.     

三种前列腺素类药物降眼压效果比较

目的比较拉坦前列素、曲伏前列素和贝美前列素三种前列腺素类药物的降眼压效果。方法选取原发性开角型青光眼和高眼压症患者,拉坦前列素组51例(51眼),曲伏前列素组24例(24眼),贝美前列素组27例(27眼),分别使用相应滴眼液,均为每日1次,共观察4周,测量用药前后的眼压值。结果三组患者用药4周后眼压均有明显下降,拉坦前列素组在8:30测得平均眼压从(24.57±3.68)mmHg(1 mmHg=0.133 kPa)降至(15.29±2.67)mmHg,下降幅度(用药前后眼压差值/用药前眼压值)为37.8%;曲伏前列素组从(24.54±2.95)mmHg降至(16.29±3.11)mmHg,下降幅度为33.6%;贝美前列素组从(25.41±3.63)mmHg降至(16.00±4.45)mmHg,下降幅度为37.0%。用药前及用药后三组间眼压值比较,差异均无显著性(分别为F=0.579、P=0.562;F=0.868、P=0.423)。结论拉坦前列素、曲伏前列素、贝美前列素滴眼液对于原发性开角型青光眼和高眼压症患者都有明显、持久的降眼压作用,且降眼压作用相互间没有明显差异。     

国产和进口拉坦前列素滴眼液治疗开角型青光眼及高眼压症的疗效及成本比较

目的:观察国产拉坦前列素滴眼液降眼压效果及安全性,研究进口和国产拉坦前列素滴眼液的成本—效果比。方法:采用随机、单盲、平行对照试验,选取原发性开角型青光眼和高眼压症患者,18例18眼滴用国产拉坦前列素滴眼液,14例14眼滴用进口拉坦前列素滴眼液(适利达),均每日1次,共4wk。观察眼压、视力、血压、脉搏、眼部症状和体征以及不良反应。并采用疗效观察和成本—效果分析方法对进口与国产拉坦前列素滴眼液进行经济学评价。结果:治疗4wk,验证组平均日间眼压从(24.0±3.6)mmHg(1mmHg=0.133kPa)降至(16.1±3.0)mmHg,最大下降幅度为32.9%;对照组从(24.8±3.0)mmHg降至(16.1±2.9)mmHg,最大下降幅度为35.1%。两组用药前后眼压相比均显著差异(P<0.05);各时间点两组间眼压相比均无统计学差异(P>0.05)。用药后验证组和对照组结膜充血均有明显增加,但不妨碍继续用药。未发现其他眼部改变和全身副作用。两组成本分别为119元、70元(P<0.05);眼压下降幅度分别为35%,33%(P>0.05);成本—效果比分别为3.39,2.11;进口组相对于国产组的增量成本—效果比为22.2。结论:进口与国产拉坦前列素滴眼液都能有效地降低开角型青光眼及高眼压症患者的眼内压,且安全、耐受。两组治疗开角型青光眼及高眼压症的效果相近,但国产品是更经济的选择。     

拉坦前列素、曲伏前列素和噻吗洛尔治疗原发性开角型青光眼的疗效比较分析

目的：比较拉坦前列素、曲伏前列素及噻吗洛尔滴眼液治疗原发性开角型青光眼（ POAG）的效果。方法将收治的120例患者随机分为A、B、C组,每组均为40例,其中A 组患者给予拉坦前列素滴眼液;B组患者给予曲伏前列素滴眼液;C组患者给予马来酸噻吗洛尔滴眼液,A、B组均为每天晚上约20：00给药1次,每次1滴,疗程为4周,C组为每天早上约08：00给药1次,每次1滴,疗程为4周。结果三组患者治疗前比较,眼压无统计学差异（ P ＞0．05）,三组患者用药治疗4周眼压值均有显著下降,用药前后差异具有统计学意义（ P ＜0．05）;拉坦前列素和曲伏前列素两种滴眼液组间治疗无显著性差异（ P ＞0．05）,但与噻吗洛尔治疗分别进行组间效果比对具有显著性差异（ P ＜0．05）。结论拉坦前列素、曲伏前列素及噻吗洛尔滴眼液治疗POAG在一个疗程内（4周）均能有效降低眼压,疗效持久,且两种前列素降眼压作用明显优于噻吗洛尔滴眼液治疗效果。     

三种前列腺素类滴眼液治疗原发性开角型青光眼的降眼压效果比较

目的 比较拉坦前列素、曲伏前列素及贝美前列素3种前列腺素类滴眼液治疗原发性开角型青光眼患者4周后的24h降眼压效果。方法 病例对照研究。选取2009年1月至6月门诊就诊的原发性开角型青光眼患者63例（63只眼）。其中拉坦前列素组21例（21只眼）,曲伏前列素组22例（22只眼）,贝美前列素组20例（20只眼）,分别使用相应的滴眼液,均为每日滴药1次,共观察4周,测量用药前后的24h眼压曲线。3组间用药前或用药后24h不同时间点眼压值比较采用两因素重复测量的方差分析,眼压波动幅度比较采用单因素方差分析。结果 3组患者用药4周后眼压均明显下降,拉坦前列素组眼压从(18.9±2.1)mm Hg（1mm Hg =0.133 kPa）降至(15.3±2.7)mm Hg,下降幅度（用药前后眼压差值/用药前眼压值）为19.0％;曲伏前列素组眼压从(19.1±3.1)mm Hg降至(15.3 ±2.1)mm Hg,下降幅度为19.4％;贝美前列素组眼压从(18.6±1.9) mm Hg降至(14.9±1.9)mm Hg,下降幅度为19.9％。波幅下降幅度（用药前后波幅差值/用药前波幅值）,拉坦前列素组为31.0％,曲伏前列素组为31.1％,贝美前列素组为31.9％。用药前及用药后3组间眼压值随时间点变化差异均无统计学意义(F= 1.501,P=0.110),3组间用药后眼压波幅下降幅度差异无统计学意义(F =0.286,P=0.752)。结论 拉坦前列素、曲伏前列素、贝美前列素3种滴眼液对原发性开角型青光眼的昼夜降眼压效果显著且无明显差别。     

曲伏前列素和噻吗心安治疗开角型青光眼和高眼压症的对照研究

目的:以噻吗心安为对照,观察曲伏前列素滴眼液降眼压效果及安全性。方法:采用随机对照法,0.04g/L曲伏前列素滴眼液1次/d或5g/L噻吗心安滴眼液2次/d,治疗原发性开角型青光眼和高眼压症,共34例,疗程12wk,观察眼压及不良反应。未发现其他眼部改变和全身副作用。结果:试验组平均日间眼压以24.83±2.97mmHg降至16.13±2.92mmHg;对照组从23.96±3.62mmHg降至16.14±2.97mmHg。试验组结膜充血较对照组明显增加。结论:曲伏前列素滴眼液对控制原发性开角型青光眼和高眼压症的眼压是有效和安全的。     

曲伏前列素滴眼液(速为坦)治疗原发性开角型青光眼和高眼压症的临床研究

目的观察曲伏前列素滴眼液(速为坦)降眼压效果及安全性。方法采用随机、单盲、平行对照试验,选取原发性开角型青光眼和高眼压症患者,试验组入选24例(24只眼)滴用曲伏前列素滴眼液,对照组入选23例(23只眼)滴用拉坦前列素滴眼液(适利达),均为每日1次,共观察4周。观察的指标包括眼压、视力、血压、脉搏、眼部症状和体征以及不良反应。结果1试验组平均日间眼压从(2483±297)mmHg(1mmHg=0133kPa)降至(1613±292)mmHg,最大下降幅度为352%;对照组从(2396±362)mmHg降至(1614±297)mmHg,最大下降幅度为326%。2用药后试验组和对照组结膜充血均有明显增加,试验组的眼痒明显重于对照组,但都不妨碍继续用药。未发现其他眼部改变和全身副作用。结论曲伏前列素滴眼液对控制原发性开角型青光眼和高眼压症的眼压是有效和安全的,可望成为理想的一线抗青光眼药物。     

四种前列腺素类药物的降眼压疗效和耐受性对比研究

目的　探讨四种前列腺素类药物治疗原发性开角型青光眼（primary open-angle glaucoma，POAG）的疗效和耐受性差异。方法　采用随机平行试验，64例(128眼)POAG患者随机分成4组，分别使用贝美前列素(贝美前列素组)、拉坦前列素（拉坦前列素组）、曲伏前列素（曲伏前列素组）和他氟前列素（他氟前列素组）滴眼液治疗，观察并比较4组患者用药前和用药后1个月、3个月和6个月的眼压、眼部检查和眼表疾病指数（ocular surface disease index，OSDI）评分。结果　贝美前列素组用药前眼压为（26.1±6.2）mmHg（1 kPa=7.5 mmHg），用药后1个月、3个月和6个月眼压分别为（17.1±3.4）mmHg、（15.6±4.2）mmHg、（15.5±2.9）mmHg，与用药前比较，差异均有统计学意义（t=17.408、13.016、12.352，均为P＜0.001）。拉坦前列素组用药前眼压为（24.7±2.4）mmHg，用药后1个月、3个月和6个月眼压分别为（16.3±3.0）mmHg、（17.0±3.8）mmHg、（17.4±2.6）mmHg，与用药前比较，差异均有统计学意义（t=12.238、13.365、16.140，均为P＜0.001）。曲伏前列素组用药前眼压为（24.4±1.9）mmHg，用药后1个月、3个月和6个月眼压分别为（16.3±2.0）mmHg、（17.4±1.3）mmHg、（14.9±1.1）mmHg，与用药前比较，差异均有统计学意义（t=12.109、14.451、11.732，均为P＜0.001）。他氟前列素组用药前眼压为（25.2±2.3）mmHg，用药后1个月、3个月和6个月眼压分别为（17.2±3.1）mmHg、（17.0±2.1）mmHg、（18.1±2.4）mmHg，与用药前比较，差异均有统计学意义（t=10.540、16.129、14.006，均为P＜0.001）。拉坦前列素组患者睫毛增长和虹膜变色的发生率最高，4组患者的结膜充血和角膜炎的发生率相似。用药6个月后患者的OSDI评分贝美前列素组（21.8±11.1）分、拉坦前列素组（32.1±24.1）分、曲伏前列素组（10.7±5.7）分、他氟前列素组（25.6±6.3）分，曲伏前列素组患者的OSDI评分显著低于其他3组，差异均有统计学意义（均为P＜0.05）。结论　四种前列腺素类药物均能显著降低POAG患者眼压，曲伏前列素耐受性较好，拉坦前列素的耐受性最差。     

拉坦前列素与噻吗心安治疗国人开角型青光眼和高眼压症有效性安全性Meta分析

目的：系统评价拉坦前列素(Latanoprost)滴眼液与噻吗心安(Timolol)滴眼液降眼压的有效性和安全性。

方法：计算机检索PubMed,Medline,CNKI及中国生物医学文献数据库收录的,并辅以手工检索、因特网搜索的有关拉坦前列素与噻吗心安治疗原发性开角型青光眼和高眼压症的随机对照试验(RCT)。按照纳入和排除标准限定研究对象,通过Jadad评分量表进行文献质量评估后,针对眼压下降比例、药物不良反应2项内容,使用Cochrane协作网提供的RevMan 5.0软件进行Meta分析。

结果：共纳入9项RCT,合计555例患者。Meta分析结果显示：(1)拉坦前列素滴眼液与噻吗心安滴眼液降眼压效果,在 2,6,12wk时差异均有统计学意义(P<0.01),加权平均差(WMD)分别为：在2wk\,在6wk\和12wk\。(2)随访结束时,结膜充血、异物感为拉坦前列素的两种较为常见的不良反应, 但其发生率拉坦前列素组与噻吗心安组比较, 结膜充血的发生率\〖OR=2.25,95% CI(0.99,5.08)\〗,异物感的发生率\〖OR=2.48,95% CI(1.02,6.03)\〗,显示二者差异均无统计学意义。

结论：治疗原发性开角型青光眼和高眼压症,拉坦前列素降眼压效果在用药12wk内较噻吗心安好; 两者在12wk内引起结膜充血、异物感、虹膜色素加深、视野损害等的不良反应方面,差异不明显。由于纳入研究的样本量偏小,且方法学质量中等,致使本系统评价结果论证强度不高,因此还需要开展更多的高质量的临床随机对照研究,以便更客观、准确、全面地评价其疗效和安全性。     

拉坦前列素治疗开角型青光眼的疗效观察

目的：探讨拉坦前列素治疗开角型青光眼的疗效。

方法：选择2015-08/2017-08期间在我院就诊的开角型青光眼患者100例作为研究对象,根据治疗方法的不同分为观察组和对照组,各50眼。对照组采用噻吗洛尔滴眼液治疗,2次/d,每次1滴,连续治疗12wk; 观察组采用拉坦前列素滴眼液治疗,1次/d,每次1滴,连续治疗12wk。比较两组患者治疗前后眼压、眼部血流动力学指标、视野缺损度及不良反应发生情况。

结果：治疗前两组患者眼压水平相比,差异无统计学意义(P>0.05); 治疗4、8、12wk后观察组眼压均低于对照组,差异均有统计学意义(P<0.05)。对照组治疗前后视网膜中央动脉(CRA)、睫状后短动脉(PCA)血流动力学指标相比,差异均无统计学意义(P>0.05); 观察组CRA、PCA的舒张末期血流速度(EDV)与收缩期血流速度(PSV)均较治疗前显著升高,而血管阻力指数(RI)明显下降,差异均有统计学意义(P<0.05)。治疗前两组各方位视野缺损程度相比,差异无统计学意义(P>0.05); 治疗后两组各方位缺损范围均明显缩小,且观察组患者视野缺损程度明显小于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率相比,差异无统计学意义(P>0.05)。

结论：开角型青光眼采用拉坦前列素滴眼液治疗效果显著,能够明显降低眼压,改善眼部血流动力学,缩小视野受损范围,具有良好的安全性。     

Travoprost compared with other prostaglandin analogues or timolol in patients with open-angle glaucoma or ocular hypertension: meta-analysis of randomized controlled trials

BACKGROUND: It is still uncertain whether travoprost has comparable or better efficacy compared with other prostaglandin analogues or timolol in patients with open-angle glaucoma or ocular hypertension. The authors performed a meta-analysis of randomized controlled trials to evaluate the incidence of reported side-effects and intraocular pressure (IOP)-lowering effect of travoprost versus other prostaglandin analogues (latanaprost, bimatoprost, unoprostone) or timolol. METHODS: Systematic literature retrieval was conducted in Pubmed, EMBASE, Chinese Bio-medicine Database and Cochrane Controlled Trials Register to identify the potentially relevant randomized controlled trials. The statistical analysis was performed by RevMan 4.1 software that was provided by the Cochrane Collaboration. The outcome measures were the incidence of reported side-effects (hyperaemia, iris pigmentation, eyelash changes) and mean IOP pooled over treatment visits. RESULTS: In total, 12 articles involving 3048 patients with open-angle glaucoma or ocular hypertension were included in this meta-analysis. The combined results showed that travoprost 0.004% was more effective than timolol or travoprost 0.0015% in lowering IOP, but not more effective than bimatoprost or latanoprost. Travoprost 0.004% caused a higher percentage of hyperaemia than timolol, latanoprost, or travoprost 0.0015%. There was an increased incidence of pigmentation with travoprost than timolol. Travoprost 0.004% caused a higher percentage of eyelash changes than timolol, latanoprost, or travoprost 0.0015%. CONCLUSION: According to data available, travoprost is more effective than timolol in lowering IOP in patients with open-angle glaucoma or ocular hypertension. Compared with other prostaglandin analogues, travoprost appears to be equivalent to bimatoprost and latanoprost. Although a limited number of local side-effects were reported, no serious treatment-related side-effects were reported.     

Persistency rates for prostaglandin and other hypotensive eyedrops: population-based study using pharmacy claims data

BACKGROUND: Effective management of ocular hypertension requires patients to be persistent with their treatment regimen. We evaluated patients' persistency with hypotensive eyedrops commonly used to treat glaucoma and ocular hypertension. METHODS: This large, population-based, retrospective, cohort study used pharmacy claims data for concessional patients from the Australian Pharmaceutical Benefits Scheme (July 1999-June 2005). Resupply rates for prostaglandins, beta-blockers, alpha-agonists and carbonic anhydrase inhibitors were analysed using life tables and Cox regression. Two populations, based on patients' supply histories, were examined: (i) 'new to this eyedrop'- patients who had used other hypotensive eyedrops before (presumably, previously diagnosed with glaucoma or ocular hypertension); and (ii) 'new to any eyedrop'- patients who were using their first hypotensive eyedrop (presumably, newly diagnosed with glaucoma or ocular hypertension). RESULTS: Data were obtained for 14,359,618 supplies of commonly used hypotensive eyedrops to 357,099 concessional patients. For both populations, resupply rates were highest for prostaglandins or the dorzolamide-timolol combination eyedrops, compared with beta-blockers, alpha-agonists or carbonic anhydrase inhibitors. Among the prostaglandins, there was no significant difference in the risk of ceasing supply between latanoprost and bimatoprost, but the risk was significantly higher for travoprost. CONCLUSIONS: Based on resupply rates from a national pharmacy claims database, patients supplied with ocular hypotensive eyedrops were most persistent with prostaglandin (bimatoprost, latanoprost and travoprost) and dorzolamide-timolol combination eyedrops. Among the prostaglandins, persistency was highest with, and similar between, bimatoprost and latanoprost. Persistency should be taken into account when selecting the most appropriate eyedrop to treat glaucoma and ocular hypertension.     

Latanoprost for the treatment of pediatric glaucoma

Latanoprost is a prostaglandin F(2alpha) analog that reduces intraocular pressure (IOP) by 20-40% in adults with open-angle glaucoma or ocular hypertension. The efficacy and safety of latanoprost in children has not been widely reported, but there are at least three peer-reviewed publications involving the use of this drug in the treatment of pediatric patients with glaucoma. Most of the patients in these studies showed disappointingly little IOP effect from this drug, but some children, particularly older children and those with juvenile-onset open-angle glaucoma, do have a significant ocular hypotensive effect with latanoprost. Systemic and ocular side effects in children on latanoprost are infrequent and mild.     

Comparative study of three prostaglandin analogues in the treatment of newly diagnosed cases of ocular hypertension,open‐angle and normal tension glaucoma

Background: To compare the efficacy and tolerance of three prostaglandin analogues, bimatoprost, latanoprost and travoprost in patients with previously untreated open‐angle glaucoma and ocular hypertension. Methods: Prospective randomized single (investigator) masked comparative clinical trial at the Taunton and Somerset NHS Hospital, Taunton, UK. Newly diagnosed, treatment naïve glaucoma/ocular hypertension patients were recruited. Patients were randomized into three groups to receive one of the three prostaglandin analogues. Intraocular pressure (IOP) was measured before starting treatment and after 2 and 6 months of treatment. The IOP reduction and the tolerance profile of each drug were compared. The data were analysed on the basis of intention to treat, using analysis of covariance comparing IOP in the three groups at 2 and 6 months, adjusting for baseline IOP. Tolerance levels were compared using Kruskal–Wallis test. Results: Of the 122 patients, 40 patients were given bimatoprost, 42 received latanoprost and 40 had travoprost. At 2 months, there was a significant difference between the three treatment groups (P = 0.013) with bimatoprost achieving a greater reduction in IOP than the other two drops. However, at 6 months, the difference was not statistically significant (P = 0.13). There was no significant difference in the tolerance profile. Conclusion: All the three topical prostaglandin analogues are effective at lowering IOP, but bimatoprost was found to be most effective in the initial phase of the trial, and there was no statistically significant difference in the efficacy, among the three prostaglandin analogue eye drops after 6 months of treatment.     

Timolol topical ophthalmic combination

The primary standard therapy in patients with open-angle glaucoma and ocular hypertension is carried out by means of monotherapy with synthetic prostaglandin analogues. Most of the glaucoma patients need more than one medication for adequate intraocular pressure control. Timolol represents the basic component of these combinations. Timolol topical ophthalmic combinations with dorzolamide (Cosopt), pilocarpine, latanoprost (Xalacom), travoprost and unoprostone are thoroughly described. Most antiglaucoma medications achieve on one side directly baroprotection by decreasing intraocular pressure and on the other side they produce indirectly vasoprotection, that is secondary to intraocular pressure lowering. The Cosopt, due to its Dorzolamide component, makes an exception since it produces directly both baroprotection by aqueous humor flow suppression and vasoprotection by increasing the blood flow within the retina, choroid, optic nerve head and retrobulbar area. Given these considerations as well as the fact that the ocular hypotensive effect of both the Cosopt and the latanoprost are equally potent, a question seems reasonable according to accepted standard i.e. Cosopt or latanoprost as primary glaucoma therapy?     

Ocular Redness Measured with the Keratograph 5M in Patients Using Anti-Glaucoma Eye Drops

Purpose: To examine correlations between ocular redness measured with the new topographer Keratograph 5M and the use of topical anti-glaucoma medication. Methods: A total of 211 eyes of 211 patients with open-angle glaucoma or ocular hypertension on topical medication and 51 eyes of 51 healthy volunteers were recruited over 10 months. Outcome variables were keratograph redness scores (RS): overall, bulbar temporal (BT), bulbar nasal (BN), limbar temporal (LT), and limbar nasal (LN). In each subject, we also recorded the intraocular pressure-lowering eye drops used, daily doses and daily and cumulative preservative concentrations, fluorescein corneal staining score (OXFORD), lower tear meniscus height (Fourier-domain OCT), non-invasive tear film breakup time (Keratograph 5M), and ocular surface disease questionnaire index (OSDI). Results: Higher RS were recorded in the medication than control group (P < 0.01 all scores). Within the medication group, older patients returned greater RS (P < 0.05 all scores). Prostaglandin was a strong predictor of higher scores, except LN RS. A higher OSDI was associated with a higher LN RS (β = 0.007; P < 0.05), while the use of β-blockers was linked to a lower LN RS (β = ?0.225; P < 0.05). The use of ≥3 daily eye drops with preservative gave rise to a higher BN RS and ≥3 daily eye drops to a higher LN RS (β = 0.366, P < 0.01; β = 0.296, P < 0.05, respectively). Conclusion: Keratograph 5M can objectively detect the hyperaemia induced by glaucoma medication. The factors contributing to ocular redness were advanced age, more daily eye drops (nasal sectors), a higher OSDI, and prostaglandin as the medication used.     

Comparison of ocular hypotensive effect and safety of brinzolamide and timolol added to latanoprost

PURPOSE: To compare the ocular hypotensive effect and safety of brinzolamide and timolol added to latanoprost monotherapy. METHODS: In prospective randomized fashion, we evaluated the ocular hypotensive effect and safety of brinzolamide or timolol in 1 eye of 32 patients with primary open-angle glaucoma, normal-tension glaucoma, or ocular hypertension who had been treated with latanoprost for more than 1 month. Intraocular pressure (IOP), blood pressure, and pulse were measured before and at 4, 8, and 12 weeks. Corneal endothelial cell density was measured at baseline and at 12 weeks. RESULTS: The IOP was 17.8+/-1.7 mm Hg (mean+/-SD) before the addition of brinzolamide (n=15) and 15.7+/-2.1 mm Hg at 12 weeks (P<0.01). In comparison, the IOP was 18.5+/-3.7 mm Hg before the addition of timolol (n=15) and 15.8+/-3.2 mm Hg at 12 weeks (P<0.01). Both brinzolamide and timolol significantly decreased IOP at 12 weeks, by a mean of 2.0 mm Hg and mean 2.7 mm Hg, respectively, and were more effective than latanoprost alone (P<0.01), but there were no significant differences between the drugs and no significant differences in corneal endothelial cell density and blood pressure before and after addition of either drug. At 12 weeks, pulse was decreased in patients receiving timolol (P<0.01). As systemic adverse events, there was one instance of malar flushing after brinzolamide addition and episodes of chest discomfort after timolol addition in 1 patient. Ocular adverse events were slight. CONCLUSIONS: Brinzolamide and timolol added to latanoprost have similar ocular hypotensive effects and safety in primary open-angle glaucoma, normal-tension glaucoma, or ocular hypertension.     

Efficacy and safety of latanoprost eye drops for glaucoma treatment: a 1-year study in Japan

PURPOSE: To evaluate the intraocular pressure (IOP)-lowering effect and safety of latanoprost, a prostaglandin analogue, in patients with primary open-angle glaucoma or ocular hypertension. METHOD: One hundred and twenty-four Japanese patients with primary open-angle glaucoma or ocular hypertension were enrolled in this open-labeled study and were treated with 0.005% latanoprost once daily for 1 year. RESULTS: At all follow-up visits there was a significant (P < .001) reduction in IOP compared with the baseline value. After 1 year, the IOP was reduced by 5.4 +/- 2.9 (mean +/- SD) mm Hg from a baseline value of 23.5 +/- 2.2 mm Hg. No evidence of an upward drift in the IOP was observed during the treatment period. The most frequently reported adverse ocular events were mild conjunctival hyperemia and iris pigmentation. Very few adverse systemic events were observed. CONCLUSIONS: Latanoprost eye drops showed a marked and stable IOP-lowering effect during the 1-year treatment period. Furthermore, latanoprost was well-tolerated and should be a valuable contribution to the management of glaucoma.