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Abstract #21556 Published in IGR 10-3
Safety and efficacy of travoprost adjunctive treatment in paediatric glaucoma
Helmanova I; Autrata R; Senkov K; Rehurek JScripta Medica Facultatis Medicae Universitatis Brunensis Masarykianae 2007; 80: 29-36
Although medical therapy with ocular hypotensives may delay the need for surgery in some paediatric glaucomas, most patients require repeated surgical interventions. To reach an effective control IOP, children often require a long-term adjunctive glaucoma medication after surgery. Travoprost (Travatan, Alcon) is a prostaglandin analogue reducing intraocular pressure (IOP) via enhancement of uveoscleral outflow, and the IOP-lowering effect has been shown to be additive in combined therapy with other ocular hypotensive agents. The purpose of this study was to evaluate the effectiveness and safety of travoprost therapy in children with glaucoma. This study was designed as a prospective study of the patients who were administered travoprost at our clinic between January 2002 and December 2005. Seventy-three eyes of 58 paediatric patients with a variety of glaucoma diagnoses were included in the study, and were observed with an average of 28 months (range 18 to 48 months). The mean age of the patients was 7.6 years (range, 8 months to 16 years). Responders were defined as those who had at least a 10% IOP reduction, whereas nonresponders had less than a 10% IOP reduction on travoprost. The baseline IOP was compared with the IOP during the whole time of travoprost therapy for each patient; visual acuity and side effects were noted at each follow-up examination. The mean pretreatment IOP was 26.7 ± 5.9 mmHg, whereas the post-treatment IOP was 21.4 ± 7.8 mmHg. The mean IOP reduction for this group after the addition of travoprost was 11.6% (5.3 mmHg). Thirty-five patients (52 treated eyes) were responders, with an average IOP reduction of 7.8 mmHg (30.6%), whereas 23 patients were nonresponders. In the responders, there was a good correlation between baseline IOP and the magnitude of IOP reduction. The juvenile open-angle glaucoma and aphakic glaucoma were the most common diagnoses in responders and they were older than nonresponders. Systemic and ocular side effects were rarely noted. Travoprost administration was well tolerated during the study follow-up, with an excellent systemic and ocular safety profile. Travoprost was found as effective in 60% of paediatric patients with primary and secondary glaucoma and combined additive antiglaucoma medications.
Dr. I. Helmanova, Department of Paediatric Ophthalmology, Faculty of Medicine, Masaryk University Hospital, Brno, Czech Republic
Classification:
11.4 Prostaglandins (Part of: 11 Medical treatment)
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
