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Abstract #6223 Published in IGR 2-2
Effects of glaucoma medications on the cardiorespiratory and intraocular pressure status of newly diagnosed glaucoma patients
Waldock A; Snape J; Graham CMBritish Journal of Ophthalmology 2000; 84: 710-713
AIMS: To evaluate the short-term cardiovascular, respiratory, and intraocular pressure (IOP) effects of four glaucoma medications in newly diagnosed glaucoma patients. METHODS: One hundred and forty-one newly diagnosed glaucoma patients were recruited and underwent a full ocular, cardiovascular, and respiratory examination, including an electrocardiogram (ECG) and spirometry. They were prescribed one of four topical glaucoma medications and reviewed three months later. One eye of each patient was randomly chosen for analysis, performed using analysis of variance and the chi sup(2) test. RESULTS: Latanoprost had the greatest mean IOP lowering effect in both the primary open angle glaucoma (POAG) (p = 0.005) and the 'presumed' normal tension glaucoma (NTG) groups (p = 0.33), reducing the IOP by 8.9 and 4.1 mmHg, respectively. Timolol was associated with lowered pulse rates and reductions in the spirometry measurements. Forty-one percent of patients using brimonidine complained of systemic side-effects and over 55% of patients using betaxolol complained of ocular irritation; 28% of patients required an alteration in their glaucoma management. CONCLUSIONS: Latanoprost appears to be a useful primary treatment for glaucoma patients, in view of superior IOP control and a low incidence of local and systemic side-effects. Timolol causes a reduction in measurements of respiratory function, a concern in view of the potential subclinical reversible airways disease in the elderly glaucoma population. Brimonidine is associated with substantial, unpredictable systemic side-effects and betaxolol causes ocular irritation and weak IOP control. Spirometry is advised in all patients receiving topical beta-blocker therapy to control their glaucoma.
Dr. A. Waldock, Bristol Eye Hospital, Lower Maudlin Street, Bristol BS1 2LX, UK
Classification:
12.1 General management, indication (Part of: 12 Surgical treatment)
