Preservative-free latanoprost has at least the same intraocular pressure-lowering efficacy as benzalkonium chloride-latanoprost, with a better tolerability profile. This may translate into greater control of treatment and improved quality of life.

Purpose:The aim of the study was to compare the optical coherence tomography (OCT) parameters of the optic nerve head (ONH) and retinal nerve fibre layer (RNFL) and to identify which measurements are best able to differentiate between normal and glaucoma suspect eyes. Methods:The study included 27 eyes with ocular hypertension (OHT), 33 eyes with pre-perimetric glaucoma (PG), 30 perimetrically unaffected eyes of patients with glaucoma in the fellow eye (FE) and 58 eyes of age-matched normal volunteers. All subjects underwent a complete eye examination with standard automated perimetry, optic disc photography and OCT imaging. Peripapillary 'fast RNFL thickness scans' and 'fast optic disc scans' were performed with time-domain OCT. The ONH and RNFL parameters were compared among the four study groups. The ONH and RNFL parameters were examined alone and then combined via four linear discriminant functions (LDF): LDF 1, the optimal combination of ONH parameters; LDF 2, the optimal combination of RNFL parameters; LDF 3, the optimal combination of both ONH and RNFL parameters; and LDF 4, the optimal combination of the best 11 parameters. The areas under the receiver operating curves (AUC) and the sensitivity at fixed specificity of at least 80 and 95 per cent were calculated for single parameters and LDF combinations and then compared. The best 11 parameters were selected based on their AUC values. Results: Comparative analysis of OCT parameters revealed statistically significant differences in all seven ONH parameters in both PG and FE groups (and only in one ONH measurement in the ocular hypertensive group) when compared with normal eyes. Most of the RNFL parameters demonstrated statistically significant differences in all of the study groups when compared with the control group. The max-min parameter (0.835), inferior quadrant (0.833) and average RNFL thickness (0.829) obtained the highest AUC values in the whole glaucoma suspect group. The rim area had the best diagnostic accuracy among the ONH parameters (AUC = 0.817). The AUC values of the four LDF were: 0.825 (LDF 1), 0.882 (LDF 2), 0.902 (LDF 3) and 0.888 (LDF 4). Statistically significant differences were found between the AUC values of the single best ONH and RNFL parameters and LDF 3 and LDF 4. Conclusions: In the present study, RNFL parameters presented with better discriminatory abilities than ONH parameters in the OHT and FE groups. The ONH parameters demonstrated better diagnostic precision in differentiating between PG and normal eyes. The average RNFL thickness, max-min parameter and inferior quadrant RNFL thickness had the best abilities among single OCT measurements for discriminating between glaucoma suspect (including all ocular hypertensive, PG and FE eyes) and normal eyes. The combination of RNFL parameters only or both ONH and RNFL parameters, using linear discriminant analysis, provided the best classification results, improving the diagnostic accuracy of the instrument.

Background. Diabetic macular edema (DME) is responsible for three-quarters of vision-loss cases in diabetic eye disease. In most cases, early treatment by laser photocoagulation can only stabilize vision. Glucocorticoids have been used as a local pharmacological treatment in DME when the inflammation seems to have a pathological background.

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Palabras clave: Anafilaxia. Albumina humana en suero. Plasma humano. Prueba de activación de basófilos. Inmunoblot.

Purpose To compare the tolerance and efficacy of preservative‐free latanoprost (latanoprost‐PF) after switching from benzalkonium chloride containing agent (latanoprost‐BAK). Methods 140 patients with glaucoma or OHT controlled by latanoprost–BAK were included into the study. At a baseline visit (D0) a new formulation of latanoprost‐FP (Monoprost ®, Laboratoires Thea) was introduced. An observation was conducted, including three visits after 15, 45 and 90 days from the baseline (D15, D45, D90 respectively). The following outcomes were evaluated: BCVA, IOP, TBUT, corneal fluorescein staining and subjective assessment of tolerance by patient using 10‐ point VAS scale (0 ‐ very good, 10 ‐ very poor tolerance). Results Mean IOP during all subsequent visits was reduced compared to the baseline (p <0.006 vs D0) and measured 15.95 mmHg,15.37 mmHg, 15.33 mmHg and 15.27 mmHg at D0, D15, D45 and D90, respectively. TBUT was improved in 23.4% of patients at D45 and in 29.7% of patients at D90, but deteriorated in 8% of cases at both time points. It remained unchanged in 68.6% and 62%of patients at D45 and D90, respectively. A conjunctival hypaeremia was present in 56.8% and in 13,7%, 2,2% and 1,6% of patients at D0, D15, D45 and D90 visits, respectively. Subjective assessment of tolerance showed an improvement from 5.3 at baseline to 1.91 at D90 (p <0.0001). Conclusion Preservative‐free latanoprost has at least the same IOP‐lowering efficacy in comparison to BAK‐preserved latanoprost. Latanoprost‐PF has a better tolerability profile which may translate into better control of the treatment and better quality of life for the patient.