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Abstract #8079 Published in IGR 4-3
Comparative effects of latanoprost (Xalatan) and unoprostone (Rescula) in patients with open-angle glaucoma and suspected glaucoma
Sponsel WE; Paris G; Trigo Y; Pena MAmerican Journal of Ophthalmology 2002; 134: 552-559
PURPOSE: To compare, in paired eyes of open-angle glaucoma patients and glaucoma suspects, hydrodynamic and visual changes after one month of topical latanoprost in one eye and unoprostone in the other. DESIGN: Single-center, institutional randomized clinical trial. METHODS: After completing a washout period off all topical medication, 25 adults (mean age 54 ± SEM two years) with bilateral open-angle glaucoma or glaucoma suspect status underwent morning (8-1 a.m.) and afternoon (1-3 p.m.) measurements of intraocular pressure (IOP), pulsatile ocular blood flow (POBF), contrast, sensitivity, frequency doubling technology, and Humphrey 10-2 perimetry (HVFA II) in both eyes. Each then started unoprostone 0.15% (Rescula) in one randomly assigned eye and latanoprost 0.005% (Xalatan) in the other. Unoprostone was administered at 8 a.m. and 8 p.m. and latanoprost at 8 p.m. with placebo at 8 a.m., both from masked bottles. After 28 days, differences were determined for each measured variable by two-tailed paired t test.RESULTS: Starting from similar baseline IOP levels, after 1 month of treatment, the mean morning IOP values differed according to the topical agent received (16.2 ± SEM 0.6 mmHg for latanoprost versus 17.9 ± 0.7 mmHg for unoprostone; p = 0.001). These morning pressures were 2.6 mmHg lower than baseline in the eyes receiving latanoprost (p < 0.0001), and 1.6 mmHg lower in unoprostone-treated eyes (p = 0.02). Afternoon values were 3.1 ± SEM 0.6 lower than corresponding baseline in eyes receiving latanoprost, and 2.4 ± SEM 0.6 mmHg in unoprostone-treated eyes (p < 0.0001 from baseline for both medications; interdrug mean IOP difference; p = 0.04). Eyes receiving unoprostone showed a 1.7-dB improvement in frequency doubling mean deviation (p = 0.03), the only significant visual function change observed. Pulsatile ocular blood flow increased 30% relative to baseline in eyes receiving latanoprost, (p < 0.0001) and 16% in eyes receiving unoprostone (p = 0.05) by the morning of day 28. That afternoon, mean POBF had increased 30% (p < 0.0001) relative to afternoon baseline values among eyes receiving latanoprost and 18% (p = 0.03) among those receiving unoprostone (interdrug change difference, p = 0.05). Humphrey perimetry and contrast sensitivity remained stable with both prostanoids. CONCLUSIONS: Both latanoprost and unoprostone produced significant reductions in IOP and increases in POBF, with stable central and perimacular visual function. Latanoprost once daily produced IOP reduction and POBF increases nearly two-fold greater than those obtained with unoprostone twice daily. These differences in IOP and POBF change between unoprostone and latanoprost were statistically significant.
W.E. Sponsel, MD, Department of Ophthalmology, University of Texas Health Science Center, San Antonio, TX 78229, USA. sponsel@uthscsa.edu
Classification:
11.4 Prostaglandins (Part of: 11 Medical treatment)
