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Abstract #6481 Published in IGR 3-2
A 7 year prospective comparative study of three topical β blockers in the management of primary open angle glaucoma
Watson PG; Barnett MF; Parker V; Haybittle JBritish Journal of Ophthalmology 2001; 85: 962-968
AIM: To determine the long-term efficacy of monotherapy with topically applied β blocking agents and to determine whether selective β blockers were able to preserve the visual field more effectively than nonselective agents. METHODS: A prospective randomized, open, comparative study of three topically applied β blockers, timolol, betaxolol, and carteolol, was carried out on 153 patients (280 eyes) with newly diagnoses open-angle glaucoma (OAG). Those patients who were not withdrawn were followed by the same observers for a minimum of two years and a maximum of seven years, with clinical observations, Goldmann tonometry, and 24.2 Humphrey visual field analysis. RESULTS: All three drugs lowered the intraocular pressure (IOP) significantly from untreated levels, but betaxolol tool up to 12 months in some instances to reach the maximum pressure reduction. After seven years, only 43% of the eyes begun on timolol, 34% of those started on carteolol, and 29% of those on betaxolol were still being treated with these medications alone. Visual fields were analyzed throughout the trial by CPSD and MD and at the end by linear regression analysis (Progressor). The visual fields remained the same without apparent improvement or deterioration throughout the period of follow-up. Eight patients (11 eyes) were withdrawn because of continuing field loss despite reduction in IOP (six using carteolol and five betaxolol). CONCLUSIONS: Analysis shows that less than half the eyes initially treated with topical β blockers might be expected to still be being treated with their original medication after five years. The rest required either additional medication or trabeculectomy. There was no statistically significant improvement or deterioration in the visual fields over a seven-year period. On the evidence of this trial, there are no particular advantages to using selective β blockers.
Mr. P.G. Watson, 17 Adams Road, Cambridge, CB3 9AD, UK
Classification:
11.3.4 Betablocker (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
