The long term effects of two dose regimens of latanoprost (PhXA41) administered to eyes concomitantly treated with timolol which had not adequately been controlied by timolol alone were compared. A total of 50 patients, 17 with primary open angle glaucoma and 33 with capsular glaucoma, were recruited from five clinics. All had glaucomatous visual field defects and an intraocular pressure (IOP) of at least 22 mm Hg despite treatment with 0*5% timolol twice daily. Patients were randomised to two treatment groups. In one group 0.006% latanoprost was given twice daily, in the other group placebo was given at 8 am and latanoprost at 8 pm for 3 months, with concomitant timolol treatment in both groups. Average daytime IOP (mean (SD)) at baseline (on timolol alone) and after 4 and 12 weeks' treatment was 24*8 (3.6), 16-8 (4.3), and 15*7 (2.4) mm Hg respectively with once daily application of latanoprost and 24-9 (2.9), 18*1 (3.0), and 18-0 (3.6) mm Hg respectively with latanoprost twice daily. No clinically significant side effects were observed during treatment. Latanoprost causes a marked and sustained IOP reduction in eyes which are also being treated with timolol. Latanoprost given once daily is at least as effective and probably superior to a twice daily dose regimen (BrJ Ophthalmol 1995; 79: 12-16) Several previous studies have demonstrated that the phenyl substituted prostaglandin F2a analogue, 13,14-dihydro-17-phenyl-18, 19, 20-trinor-prostaglandin F2a-isopropylester (latanoprost, PhXA41) and its epimeric mixture PhXA34 reduce significantly the intraocular pressure (IOP) in normal, ocular hypertensive, or glaucomatous eyes."18 The present study was undertaken to obtain more information on dose regimen, long term effect, and additivity to a 13 adrenergic antagonist, timolol.Latanoprost has a long duration of effect on IOP, but whether it should be administered once of twice daily is unclear. In two dose finding studies with the epimeric mixture PhXA34 a duration ofat least 24 hours was observed but the effect 24 hours after the dose was less pronounced than that seen at 12 hours after the dose.' 2 Such an attenuation of the effect was not observed in a study on hospitalised patients treated with latanoprost,7 and in one dose regimen study administration of 0-006% latanoprost once daily was at least as effective as twice daily.4In a first dose finding study with twice daily administrations of latanoprost, ocular hypertensive eyes were treated for 4 weeks.5 There was no significant difference between the three concentrations of latanoprost eye drops used; 0 0035%, 0 006%, and 0-0115%, and all were significantly better than placebo. The initial response, on the second day of treatment, was good with a 31-38% reduction of the IOP, but after 1 week of treatment there was some diminution of effect and after 4 weeks the IOP reduction was between 19 and 22% for the three concentrations of latanoprost used. A partial diminution in the IOP effect was also observed by Camras et al after 5 days of treatment t...

ABSTRACT.Purpose: The aim of the study was to assess efficacy and side effects of latanoprost during two years of treatment.

No abstract

Conclusions-Latanoprost and dipivefrin have an additive eVect on IOP and no clinically significant eVect on the permeability to proteins of the blood-aqueous barrier. This implies that the two drugs can be a useful combination for the treatment of glaucoma. (Br J Ophthalmol 1998;82:404-406)

Of all patients attended to in a clinic during 1986, 441 had open angle glaucoma diagnosed during 1974-1986 on the basis of either a verified visual field defect, a glaucomatous disc, or a repeated intraocular pressure value of at least 35 mm Hg.At first presentation of recent cases 1984-1986 (N=128) 65 per cent were more than 70 years old. Capsular glaucomas were twice as common as simple glaucomas (low tension cases included).62 per cent of capsular but only 26 per cent of simple glaucomas had an initial pressure of 35 mm Hg or more (p

SUMMARYThe retina contains Na+K+-ATPase and carbonic anhydrase (CA), enzymes that regulate ion fluxes across cell membranes of photo receptors. Since inhibi tion of retinal Na+K+-ATPase by digitalis impairs colour vision, we wanted to find out whether this also occurs after inhibition of CA. In a double-masked cross over study with placebo, 14 male volunteers were given 50 mg q.i.d. of the CA inhibitor methazolamide for 2 weeks. A disturbance of colour discrimination was observed in 8 of the 14 subjects, in the classification phase of Lanthony New Color Test. The presence of the disturbance was not significantly correlated to the degree of acidosis or to other side-effects. Its mechan ism could be interpreted as a specific effect of CA inhibition in the retina (or the visual cortex) calculated to more than 99.9%.The retina contains Na+K+-ATPasel and carbonic anhydrase 2 ,3 (CA; carbonate hydro lyase EC 4.2.1.1), enzymes that directly or indirectly regulate ion fluxes across cell membranes of the photoreceptors. 4 ,5 Inhibition of Na+K+-ATPase by digitalis has been found to impair blue-yellow (in mild digitalis intoxication) and red-green (in severe intoxication) colour vision. 6 , 7 This effect can be conveniently evaluated by the Farnsworth-Munsell lOa-Hue Test. 8 It was therefore of interest to find out whether colour vision is affected by inhibition of CA also, and if so, whether this is related to other side-effects known to occur 9 , 1 0 in patients given CA inhibitors.