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NPDS appears to be an effective and safe filtering procedure for lowering IOP and could be an alternative to trabeculectomy in open angle glaucoma with the advantage of having fewer complications.

It has been suggested that low tension glaucoma (LTG) could be the consequence of a hemodynamic crisis or chronic occlusive disease. The purpose of the present study was to test this hypothesis by comparing three groups of patients matched for age and sex: 51 patients with LTG, 51 patients with open angle glaucoma (OAG) and 46 control patients. Clinical symptoms and history of occlusive arterial disease and conditions which could be associated with or were the consequence of acute blood pressure lowering were not more frequent in the LTG group. The prevalence of rhythm and conduction abnormalities on the ECG was two times more frequent in the glaucoma groups, but the differences were not statistically significant. Mean cardiovascular risk factor levels were not higher in the LTG group than in the two other groups. But the mean difference of blood pressure between the standing and lying positions was significantly greater in the LTG group (systolic blood pressure: ––6.9mmHg) than in the OAG group (––1.2 mm HG) and the control group (––1.5mmHg). These results suggest that postural hypotension could play a role in the pathogenesis of LTG.

Background/aim-Carteolol is a adrenoceptor antagonist used topically to reduce intraocular pressure, typically twice daily. In an eVort to provide a once daily dosing regimen, carteolol was formulated with 1% alginic acid. The objective of this study was to evaluate the eYcacy and safety of carteolol alginate solution in comparison with standard carteolol solution.Methods-This was a double masked, parallel group, multicentre study. Patients with ocular hypertension or open angle glaucoma (n=235) were randomly assigned to receive either carteolol alginate four times daily or standard carteolol solution, twice daily. The masking was maintained through the use of a vehicle in the evening for the alginate group. Patients were evaluated at baseline, 15, 60, and 120 days. Results-At 0900 (presumed trough) on day 60, mean reductions in intraocular pressure (IOP) from baseline were 6.09 (SD 2.97) and 6.09 (3.18) mm Hg for the standard carteolol and alginate, respectively. At 1100 (presumed peak), mean reductions were 6.51 (2.53) and 6.47 (2.76) mm Hg, respectively. Results were similar at other times (day 15 and day 120). The most common side eVect was transient stinging on instillation of drops, which did not diVer significantly between groups. There were no diVerences of note in other ocular or systemic signs or symptoms. Conclusion-The new alginate formulation of carteolol 2% given once daily was as eVective as standard carteolol 2% given twice daily with no meaningful diVerences regarding safety. (Br J Ophthalmol 2001;85:921-924)

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