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Abstract #15791 Published in IGR 2-3
Long-term effects of timolol therapy in ocular hypertension: a double-masked, randomised trial
Heijl A; Bengtsson BGraefe's Archive for Clinical and Experimental Ophthalmology 2000; 238: 877-883
BACKGROUND: Increased intraocular pressure (IOP) has been shown to be one of the most important risk factors for developing glaucoma. Yet, it has not been clearly demonstrated that IOP-lowering treatment can reduce the incidence of glaucoma damage in patients with ocular hypertension. The aim of the current paper was to report the results of a long-term study addressing this very problem. METHODS: The authors conducted a randomized, double-masked study comparing timolol and placebo treatment in 90 patients with ocular hypertension plus some additional risk factor. Patients were followed at three-month intervals prospectively for ten years or until glaucomatous field loss could be demonstrated with computerised perimetry. A post-study analysis was performed including all available data, thus extending maximum follow-up to 17 years. RESULTS: After five years of follow-up, eight patients in the placebo group and five patients in the timolol group had developed glaucomatous field loss (NS); the corresponding figures after ten years were 15 patients in the placebo group and seven in the timolol group. Survival analysis showed a tendency but no statistically significant difference between treatment groups (p = 0.07). Study attrition was large. Eighteen patients in each group had developed glaucomatous field loss when post-study data were also included. IOP reduction was greater in eyes passing the ten-year visit without field loss (5.7 mmHg), than in those that reached an endpoint (2.3 mmHg; p = 0.0002). CONCLUSIONS: In this long-term study, the authors found a tendency for, but failed to prove a beneficial effect of, topical timolol treatment in patients with elevated IOP, normal visual fields and some additional risk factor. The intent-to-treat analysis showed no difference between treatment groups. The high attrition shows the difficulties associated with very long follow-up.
Dr. A. Heijl, Department of Ophthalmology, Malmö University Hospital, 20502 Malmö, Sweden
Classification:
11.3.4 Betablocker (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
