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Abstract #8090 Published in IGR 4-3
Changes in intraocular pressure and ocular perfusion pressure after latanoprost 0.005% or brimonidine tartrate 0.2% in normal-tension glaucoma patients
Liu CJ; Ko YC; Cheng CY; Chiu AW; Chou JC; Hsu WM; Liu JHOphthalmology 2002; 109: 2241-2247
OBJECTIVE: To evaluate and compare the effects of latanoprost 0.005% once daily and brimonidine tartrate 0.2% twice daily in patients with normal-tension glaucoma (NTG). DESIGN: A randomized, open-label, crossover study. PARTICIPANTS: Twenty-eight NTG patients with progressive visual field defects/optic disc excavation, new disc hemorrhage, or field defects that threatened fixation. INTERVENTION: Patients were randomly allocated to one of two groups. Patients in group 1 were treated with latanoprost, lubricant, and brimonidine for four weeks each, whereas patients in group 2 were treated with brimonidine, lubricant, and latanoprost for four weeks each. MAIN OUTCOME MEASURES: Intraocular pressure (IOP), pulse rate, and blood pressure were measured at 8 a.m., 12 noon, and 4 p.m. after each four-week treatment. Ocular perfusion pressure (OPP) was calculated. RESULTS: Latanoprost and brimonidine reduced the average IOP by 3.6 ± 1.9 mmHg (p < 0.001) and 2.5 ± 1.3 mmHg (p < 0.001), respectively, with a significant difference between the two regimens (p = 0.009). Both drugs significantly reduced IOP at each time point. Latanoprost decreased IOP significantly more than did brimonidine at 8 a.m. (11.7 ± 2.2 versus 13.7 ± 2.1 mmHg, p = 0.004) and 4 p.m. (11.4 ± 2.1 versus 13.2 ± 2.9 mmHg, p = 0.004), but IOP was equal between the two agents at 12 noon (11.5 ± 2.6 versus 11.5 ± 2.3 mmHg, p = 0.967). IOP was maintained at 12 mmHg or lower in 18 (66.7%) of 27 patients after treatment with latanoprost and in nine (33.3%) of 27 patients after treatment with brimonidine. Latanoprost monotherapy reduced IOP by 30% in eight patients (29.6%), but brimonidine monotherapy did not reduce IOP by that much in any of the patients. OPP increased after latanoprost treatment (p < 0.001) but did not increase after brimonidine treatment (p = 0.355). There was no significant change in pulse rate or blood pressure. CONCLUSIONS: Both latanoprost and brimonidine reduce IOP in NTG patients. Brimonidine has a peak IOP-lowering effect equal to that of latanoprost but produces a higher mean diurnal IOP than does latanoprost because of its shorter effect. Latanoprost might favorably alter optic disc blood perfusion by increasing OPP.
C.J. Liu, MD, Department of Ophthalmology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-Pai Road, Taipei, Taiwan
Classification:
11.3.3 Apraclonidine, brimonidine (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
11.4 Prostaglandins (Part of: 11 Medical treatment)
