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Abstract #6180 Published in IGR 2-2
Effect of timolol, latanoprost, and dorzolamide on circadian IOP in glaucoma or ocular hypertension
Orzalesi N; Rossetti L; Invernizzi T; Bottoli A; Autelitano AInvestigative Ophthalmology and Visual Science 2000; 41: 2566-2573
PURPOSE: To compare the around-the-clock intraocular pressure (IOP) reduction induced by timolol 0.5%, latanoprost 0.005%, and dorzolamide in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT). METHODS: In this crossover trial, 20 patients with POAG (n = 10) or OHT (n = 10) were treated with timolol, latanoprost, and dorzolamide for one month. The treatment sequence was randomized. All patients underwent measurements for four 24-hour tonometric curves: at baseline and after each one-month period of treatment. The patients were admitted to the hospital, and IOP was measured by two well-trained evaluators masked to treatment assignment. Measurements were taken at 3, 6, and 9 a.m. and noon, and at 3, 6, and 9 p.m. and midnight by a hand-held electronic tonometer (TonoPen XL; Bio-Rad, Glendale, CA) with the patient supine and sitting, and a Goldmann applanation tonometer (Haag-Streit, Bern, Switzerland) with the patient sitting at the slit lamp. Systemic blood pressure was recorded at the same times. The between-group differences were tested for significance by means of parametric analysis of variance. The circadian IOP curve of a small group of untreated healthy young subjects was also recorded using the same procedures. To compare the circadian IOP rhythms in the POAG-OHT and control groups, the acrophases for each subject were calculated. RESULTS: When Goldmann sitting values were considered, all the drugs significantly reduced IOP in comparison with baseline at all times, except for timolol at 3 AM. Latanoprost was more effective in lowering IOP than timolol at 3, 6, and 9 a.m. (p = 0.03), noon (p = 0.01), 9 p.m., and midnight (p = 0.05) and was more effective than dorzolamide at 9 a.m., noon (p = 0.03), and 3 and 6 p.m. (p = 0.04). Timolol was more effective than dorzolamide at 3 p.m. (p = 0.05), whereas dorzolamide performed better than timolol at midnight and 3 a.m. (p = 0.05). An ancillary finding of this study was that in the group of healthy subjects, the pattern of IOP curve was different that in patients with eye disease. CONCLUSIONS: Latanoprost seemed to lead to a fairly uniform circadian reduction in IOP, whereas timolol seemed to be less effective during the night-time hours. Dorzolamide was less effective than latanoprost but led to a significant reduction in nocturnal IOP. The reason for the difference in the pattern of the IOP curve of healthy subjects is currently unknown and deserves further investigation.
Dr. N. Orzalesi, Eye Clinic, Institute of Biomedical Sciences, San Paolo Hospital, University of Milan, Milan, Italy. orzalesi@mailserver.unimi.it
Classification:
11.3.4 Betablocker (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
11.4 Prostaglandins (Part of: 11 Medical treatment)
11.5.2 Topical (Part of: 11 Medical treatment > 11.5 Carbonic anhydrase inhibitors)
