Contralateral intraocular pressure lowering effect of prostaglandin analogues

Abstract

Background:Though the use of prostaglandin analogues (PGA) for reduction of intraocular pressure (IOP) has shown a marked increase, studies evaluating the contralateral effects of PGA are limited.Aims:To evaluate if PGA treatment in one eye has an effect on the IOP of the untreated fellow eye.Design:Retrospective study.Materials and Methods:Thirty patients of open-angle glaucoma with no previous antiglaucoma treatment underwent 24-hour diurnal IOP phasing. They subsequently were started on a uniocular trial with PGA, and had office diurnal IOP measurements 6 weeks later. Twenty-four hour diurnal consisted of 8 IOP readings over 24 hours and office diurnal consisted of 4 IOP readings between 8 AM and 6 PM at 3 hourly intervals.Statistical Analysis:IOPs of the fellow eye during the office diurnal were compared with IOPs at similar time points during the 24-hour diurnal using paired t-tests.Results:Mean (± standard deviation) IOP in the treated eye reduced (P < 0.001) from 17.17 ± 3.2 mm Hg at baseline to 13.7 ± 2.4 mm Hg at 6 weeks, while that in the untreated eye reduced from 16.4 ± 3.1 mm Hg to 14.8 ± 2.7 mm Hg (P = 0.01). The decrease in IOP in the untreated fellow eye was statistically significant at 8 AM (2.7 mm Hg, P = 0.003) and 11 AM (2.3 mm Hg, P = 0.01) but not so at 2 PM (1.2 mm Hg, P = 0.10) and 5 PM (0.9 mm Hg, P = 0.19). The amount of IOP reduction in the untreated eye was significantly associated with the magnitude of IOP reduction in the treated eye (β = 0.69, P = 0.008).Conclusion:Uniocular PGA treatment tends to reduce the IOP of the untreated fellow eye.

Phase 1B study of the safety and tolerability of the mineralocorticoid fludrocortisone acetate in patients with geographical atrophy

“…Clinical studies have previously reported previously that monocular treatments can affect fellow eyes,30–32 meaning that comparison of measures between treated and fellow eyes cannot serve as valid controls, and that population norms are the most useful comparators. Given that both the treated and fellow eyes showed a slower progression rate compared with previous reports, there may also be a similar sympathetic response in the fellow untreated eye.…”

Magnesium Hydroxide Nanoparticles Improve the Ocular Hypotensive Effect of Twice Daily Topical Timolol Maleate in Healthy Dogs

“…Furthermore, if contralateral ocular hypotension is caused by TM flowing into the contralateral eye via the plasma, then TM would also affect the iris sphincter muscle, meaning the contralateral eye must cause miosis in dogs. Other possible mechanisms proposed for the contralateral effects are the centrally mediated effect of a systemically absorbed drug and a consensual reaction related to changes in IOP in the treated eye [ 15 , 42 ]. Our results of a contralateral ocular hypotensive effect might have been caused by these mechanisms.…”

Comparison between Latanoprost, Travoprost, and Tafluprost in reducing intraocular pressure fluctuations in patients with glaucoma

“…One eye has been chosen for each patient to minimize the bias that might be induced by the cross-over effect of the drugs and the variability of patients’ response to treatment. 14…”