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AIM: To evaluate 24 h intraocular pressure (IOP) and blood pressure (BP) with bimatoprost or latanoprost in patients with normal-tension glaucoma. DESIGN: Prospective, randomised, crossover, active-controlled, observer-masked study. METHODS: After a 6-week medicine-free period, we randomised patients to either latanoprost or bimatoprost for 8 weeks and then to the opposite medicine for 8 weeks. At baseline, and at the end of each treatment period, we evaluated IOP and BP at 08:00 and then every 2 h over the 24 h day. Diastolic ocular perfusion pressure (DOPP) was calculated from the above parameters. RESULTS: Forty completed patients had a 24 h untreated baseline IOP of 15.5 (2.3) mmHg, and a DOPP of 59.2 (6.1) mmHg. Both treatments lowered IOP at each time point (p < 0.006), and over the 24 h curve (p < 0.001, both medicines 13.1 mmHg, 16% decrease). No difference existed between treatments in absolute IOP, at each time point, and over the 24 h curve (p ≥ 0.26). Additionally, no differences were found between treated 24 h systolic (p ≥ 0.29) and diastolic BP (p ≥ 0.12). The mean 24 h DOPP for latanoprost was increased from baseline (3%, p = 0.031) but not for bimatoprost (2%, p = 0.21). However, no difference in DOPP existed between treatments at any time point or over the 24 h curve (p ≥ 0.17). No difference was observed between treatments for any adverse event (p > 0.05). CONCLUSIONS: In patients with normal-tension glaucoma, both bimatoprost and latanoprost reduce the 24 h intraocular pressure from untreated baseline to a similar extent. Latanoprost is associated with slightly improved ocular diastolic perfusion pressure over 24 h, but similar absolute perfusion levels to that of bimatoprost.
Dr. L. Quaranta, Department of Ophthalmology, University of Brescia, Brescia, Italy
11.4 Prostaglandins (Part of: 11 Medical treatment)
6.1.2 Fluctuation, circadian rhythms (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
6.11 Bloodflow measurements (Part of: 6 Clinical examination methods)