Background:To compare the safety and efficacy between switching to prostaglandin/timolol fixed combination eye drops (PG/timolol FCs) and adding brimonidine to PG analogue monotherapy.Methods:Eyes of 53 patients with primary open-angle glaucoma or ocular hypertension who were receiving PG analogue monotherapy were included. Participants were randomly divided into two treatment groups: one was prescribed PG/timolol FCs (switched group), and for the other, 0.1% brimonidine was added to the PG analogue (added group). Intraocular pressure (IOP), blood pressure, and pulse rate were measured after 1 and 3 months and compared to baseline values. Participants were also surveyed to determine if they had experienced systemic or topical adverse events at each study visit. IOP changes at 1 and 3 months were compared between groups.Results:Three months after changing medication, mean IOP was 14.6 ± 2.4 mmHg in the switched group and 13.7 ± 1.8 mmHg in the added group; both were significantly lower than the baseline values (switched group, 16.5 ± 2.7 mmHg; added group, 15.8 ± 2.3 mmHg; both P < 0.001). Neither the mean nor the percentage reductions in IOP were significantly different between groups at 1 and 3 months. In the added group, diastolic blood pressure was lower than that at 1 and 3 months, systolic blood was lower than that at 3 months (P < 0.01). The patients who had experienced systemic or topical adverse events were 53.8% in the added group and 40.7% in the the changed group, which was equivalent between groups (P =0.4142). Three patients (11.5%) in the added group, but none from the switched group, were excluded from analyses because of adverse events (not significant, P = 0.217).Conclusion:Switching from a PG analogue to PG/timolol FCs or to PG with brimonidine was equally safe (systemically and topically) and effective in reducing IOP. Thus, PG with brimonidine might be appropriate medication in patients who cannot use PG/timolol FCs due to repiratory or circulatory disease.
Purpose:To prospectively evaluate the safety, hypotensive effect, and preservation of visual fields of dorzolamide when added to latanoprost.Subjects and methods:This study included 46 patients (46 eyes) with primary open-angle glaucoma who had been treated with latanoprost. Dorzolamide (1%) was added to latanoprost, and the intraocular pressure (IOP) was monitored before and after 3, 6, and 12 months. The mean deviation shown by Humphrey perimetry was compared before and after twelve months of treatment. Adverse reactions were monitored over the 12-month study period.Results:The mean baseline IOP was 17.2 ± 3.0 mmHg while those after 3, 6 and 12 months of treatment were 14.9 ± 3.0 mmHg, 14.5 ± 3.2 mmHg, and 14.6 ± 2.6 mmHg respectively (P < 0.0001, 1-β(power) = 0.9999571). The absolute reduction of IOP and the percent reduction were similar after 3, 6, and 12 months of treatment. The mean deviation on Humphrey perimetry was similar before and after twelve months of treatment. Three patients discontinued dorzolamide therapy due to elevation of IOP and one patient discontinued it because of adverse reactions.Conclusion:Dorzolamide is safe and effective when used for twelve months as add-on therapy to latanoprost for open-angle glaucoma.
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