Intraocular pressure and visual field changes in normal-tension glaucoma patients treated using either unoprostone or latanoprost: a prospective comparative study

Abstract

PurposeWe conducted a prospective study in patients with normal-tension glaucoma (NTG) who received either isopropyl unoprostone or latanoprost. We compared the drugs in terms of their effects on intraocular pressure (IOP) and visual field loss progression over a 3-year period.Study designProspective, randomized controlled study.MethodsWe enrolled 48 patients with newly diagnosed NTG at Kanazawa University Hospital. Eligible patients were randomly allocated (1:1) to receive either unoprostone or latanoprost ophthalmic solutions. The primary outcomes were IOP changes and visual field deterioration within 36 months. Visual field changes were analyzed: the cumulative survival rates were calculated in terms of mean deviation, pattern standard deviation, and total deviation of the upper or lower hemi-visual field, each visual field sector, and guided progression analysis. In addition, we evaluated the progression of glaucomatous optic disc changes using fundus photography and confocal scanning laser ophthalmoscopy.ResultsThe mean pretreatment IOP was 15.0±2.4 mmHg in the Unoprostone group and 15.2±1.9 mmHg in the Latanoprost group. The mean IOP during the treatment period was 13.7±2.3 mmHg in the Unoprostone group and 13.0±1.8 mmHg in the Latanoprost group. In both groups, the IOP decreased significantly (p<0.001) from baseline after treatment. The posttreatment IOP values were significantly lower in the Latanoprost group than in the Unoprostone group (p=0.023). Regarding the 3-year cumulative survival rate of visual field loss progression, there were no significant differences between groups in any parameters of the visual field or guided progression analysis. There were no significant differences between groups in disc changes.ConclusionsNo significant differences were found between groups with regard to the visual field and structural progression in patients with NTG, although unoprostone was less effective than latanoprost in lowering the IOP.

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“…Sector analysis of TD has been reported to be effective in the evaluation of visual fields in glaucoma. 14,15,[18][19][20] In this study, there were no significant changes in MD and PSD values before and after ptosis surgery. However, in the sector analysis of TD values, while there were no significant changes in inferior TD values, there was a significant improvement in superior TD values.…”

Once-daily Preservative-free Topical Anti-glaucomatous Monotherapy – A Better Approach?

“…Latanoprost is comparable to other prostaglandin analogues in efficacy and indeed, a multicentre randomised interventional study of 411 patients showed latanoprost had a similar reduction in IOP compared with bimatoprost or travoprost. 13 In addition, latanoprost causes a greater reduction in IOP compared with unoprostone 14,15 or tafluprost. 16 Although a study has shown bimatoprost to be slightly more efficacious in lowering IOP, the same study also reported that latanoprost caused less conjunctival hyperaemia compared with bimatoprost.…”