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BACKGROUND AND PURPOSE: Brinzolamide is a new topical carbonic anhydrase inhibitor for intraocular pressure (IOP) control. It has high inhibitory activity against human carbonic anhydrase II, which is the key isoenzyme regulating aqueous humor production. We conducted this study to compare the ocular hypotensive effect and safety of 1% brinzolamide versus that of 0.5% timolol twice daily. METHODS: In a double-masked design, 50 open angel glaucoma patients who had a baseline IOP between 20 to 30 mmHg were randomized to receive either 1% brinzolamide ophthalmic solution or 0.5% timolol twice daily. After completing a 2-week pre-study screening period, patients were scheduled to receive 6 weeks of treatment. Visual acuity, IOP, slit-lamp biomicroscopy, corneal thickness, refraction status, blood pressure, heart rate, and treatment-related signs and symptoms were evaluated at follow-up visits. The eye selected for treatment was the one with the higher baseline IOP, or the right eye if the IOPs were the same in both eyes. The fellow eye served as control. RESULTS: 48 patients completed the study, and there were 24 patients in each group. A significant decrease in mean IOP was found after 6 weeks of treatment in both the brinzolamide group (-17.0%) and the timolol group (-19.7%), with no significant between-group difference in the control of IOP. The central corneal thickness of treatment eyes, measured by ultrasound pachometry, had no changed after 6 weeks of brinzolamide treatment. The study medications were generally well tolerated and no serious adverse reaction occurred during the 6-week study period. CONCLUSION: When used twice a day, topical brinzolamide is as effective as 0.5% timolol in lowering IOP in patients with open angel glaucoma.
Dr. T.-H. Wang, Department of Opthalmology, National Taiwan University Hospital, No. 7 Chung-Shan S. Rd., Taipei, Taiwan
11.5.2 Topical (Part of: 11 Medical treatment > 11.5 Carbonic anhydrase inhibitors)