Compliance with timolol treatment in glaucoma

Rotchford, Alan P; Murphy, Kathryn

doi:10.1038/eye.1998.56

Cited by 105 publications

(72 citation statements)

References 15 publications

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“…In practice, glaucoma medical adherence with topical medication is poor, 18,19 and studies suggest that fewer than half of the patients are able to maintain consistently lowered IOP with topical timolol. 20 Furthermore, o1% of topical administered drug reaches the aqueous humor. 21 Eye drops lead to significant systemic absorption (up to 80%), 22 which can result in adverse side effects, based on the types of medication used.…”

Section: Iop Reductionmentioning

confidence: 99%

“…23 Together, these factors make topical application challenging, especially in the aging population, which exhibits lower adherence and greater vulnerability to side effects. 20,22 From the standpoint of drug delivery systems, it is crucial to understand the chemical structure and mechanism of the specific drug to be delivered as well as the potential side effects associated with it. There are several classes of effective topical glaucoma medications that lower the IOP.…”

Section: Iop Reductionmentioning

confidence: 99%

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Novel drug delivery systems for glaucoma

Lavik

Kuehn

Kwon

2011

Eye

137

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Reduction of intraocular pressure (IOP) by pharmaceutical or surgical means has long been the standard treatment for glaucoma. A number of excellent drugs are available that are effective in reducing IOP. These drugs are typically applied as eye drops. However, patient adherence can be poor, thus reducing the clinical efficacy of the drugs. Several novel delivery systems designed to address the issue of adherence and to ensure consistent reduction of IOP are currently under development. These delivery systems include contact lensesreleasing glaucoma medications, injectables such as biodegradable micro-and nanoparticles, and surgically implanted systems. These new technologies are aimed at increasing clinical efficacy by offering multiple delivery options and are capable of managing IOP for several months. There is also a desire to have complementary neuroprotective approaches for those who continue to show progression, despite IOP reduction. Many potential neuroprotective agents are not suitable for traditional oral or drop formulations. Their potential is dependent on developing suitable delivery systems that can provide the drugs in a sustained, local manner to the retina and optic nerve. Drug delivery systems have the potential to improve patient adherence, reduce side effects, increase efficacy, and ultimately, preserve sight for glaucoma patients. In this review, we discuss benefits and limitations of the current systems of delivery and application, as well as those on the horizon.

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Section: Iop Reductionmentioning

confidence: 99%

Section: Iop Reductionmentioning

confidence: 99%

Novel drug delivery systems for glaucoma

Lavik

Kuehn

Kwon

2011

Eye

137

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“…[49][50][51][52][53][54][55] Clinically significant noncompliance with glaucoma medications has been well documented. One study 56 documented the prevalence of noncompliance in a Greek cohort.…”

Section: The Issue Of Compliance and Persistencementioning

confidence: 99%

“…Another study 52 was designed to assess the levels of compliance in elderly glaucoma patients on timolol eye drops. In all, 24% of patients were admitted to omitting eye drops either occasionally or frequently.…”

Section: The Issue Of Compliance and Persistencementioning

confidence: 99%

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Reducing intraocular pressure: is surgery better than drugs?

Shaarawy¹,

Haefliger²

2004

Eye

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Reducing IOP is presently the evidence based, most accepted and most practised therapeutical approach for glaucoma patients. Currently topical ocular hypotensive medications, with its different classes, as well as filtering surgery (trabeculectomy and non-penetrating glaucoma surgery) are in the forefront of therapeutic modalities for IOP reduction. This article looks at the potential advantages and disadvantages of topical medications versus filtering surgery. It does not directly address the question of initial treatment of glaucoma, or what is the better treatment of glaucoma, as other review articles had, but rather looks in a more specific on the pros and the cons of each in relation to IOP reduction. In other words this article deals with the situation once the decision has been made to reduce IOP.

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