Intraocular Pressure and Conjunctival Hyperaemia with Bimatoprost Every 48 Hours Versus Every 24 Hours

Abstract

PURPOSE:To evaluate the efficacy and tolerability of a reduced rate of bimatoprost administration. METHODS: Diurnal intraocular pressure (IOP) was recorded at 10 a.m., 2 p.m. and 6 p.m. in 40 eyes of twenty Caucasian patients (age range 56-75 years), with ocular hypertension or primary open angle glaucoma, at baseline and four weeks later. The right eye received daily bimatoprost, and in the left eye bimatoprost was administered every 48 hours at 8 p.m. Bulbar conjunctival hyperaemia was assessed by direct observation by a masked observer at baseline and at week 4 and was graded as none, minimal, mild, or moderate or severe (0 to 4). RESULTS: Baseline mean diurnal IOP in the right eye significantly (P<0.001) decreased from 25.4±2.8 to 17.8±1.8 mmHg 14 to 22 hours after daily bimatoprost. Baseline mean diurnal IOP in the left eye significantly (P<0.001) decreased from 25.2±2.0 to 19.0±1.7 mmHg 38 to 46 hours post-dose. The reduction in the right eye was significantly greater than in the left (P=0.02). The average conjunctival hyperaemia after bimatoprost every 24 and 48 hours was graded as 2.4±1.0 and 1.8±0.8 respectively and this difference was significant (P<0.01). CONCLUSION: Bimatoprost every 48 hours was less effective than daily bimatoprost (24.6 vs. 30% IOP decrease), but caused less short term conjunctival hyperaemia. This off label dose schedule may be proposed to patients complaining of ocular redness especially in the first weeks of treatment. RESUMEN OBJETIVO:Evaluar la eficacia y la tolerabilidad de bimatoprost cuando se reduce la frecuencia de administración. MÉTODOS: En 40 ojos pertenecientes a veinte pacientes de raza blanca con hipertensión ocular o con glaucoma primario de ángulo abierto, y con edades comprendidas entre 56 y 75 años, se midió la presión intraocular (PIO) durante el día al inicio del estudio y transcurridas 4 semanas. En el ojo derecho se administró bimatoprost una vez al día (cada 24 horas), y en el ojo izquierdo se administró bimatoprost cada 48 horas, a las 8 p.m. Se evaluó la hiperemia conjuntival bulbar mediante observación directa por parte de un observador (que desconocía la pauta administrada en cada ojo), tanto al inicio del estudio como en la 4ª semana del mismo. La escala utilizada (de 0 a 4) se corresponde con "ausencia de hiperemia", "hiperemia mínima", "hiperemia leve", "hiperemia moderada" o "hiperemia grave". RESULTADOS:Respecto al inicio del estudio, la PIO diurna media en el ojo derecho disminuyó significativamente (P<0,001), pasando de 25,4±2,8 a 17,8±1,8 mmHg, transcurridas entre 14 y 22 horas de la administración diaria de bimatoprost. Respecto al inicio del estudio, la PIO diurna media en el ojo izquierdo disminuyó significativamente (P<0,001), pasando de 25,2±2,0 a 19,0±1,7 mmHg, transcurridas entre 38 y 46 horas de la administración de la dosis. La disminución en el ojo derecho resultó ser significativamente mayor que la observada en el ojo izquierdo (P=0,02). La hiperemia conjuntival promedio, tras administrar bimatoprost cada 24 o cada 48 horas...

Geriatric Vision Care – a New Look at the Old

“…11 Vision assessment is recommended as a part of falls prevention programmes. 12 This Special Issue of the Journal of Optometry covers topics of critical interest to those who are involved in research into vision in the elderly or in their clinical care; management of disease in the elderly, 13 glare testing, 14 gaze behavior and balance, 15 and quality of life. 16 We learn that cataract surgery can result in successful outcomes in the oldest segment of the elderly population and that this improvement in visual acuity translates into more activities of daily living.…”