Top-three from the Canadian Glaucoma Society Meeting
Whistler, British Columbia, Canada, June 13, 2008
Yvonne Buys
Prostaglandin analogues were com-pared to other topical pressure lowering
agents in a systematic review of efficacy, side effects and cost-effectiveness.
The efficacy data showed latanoprost approximately 1 mmHg more efficacious than
both timolol and brimonidine and approximately 4 mmHg superior to dorzolamide.
Based on with-drawals from randomized clinical trials, the side effect profile
of all agents were similar, except that brimonidine caused significant-ly more
withdrawals than the other agents for topical adverse event reasons. From a
cost-effective standpoint, latanoprost was cost effective compared to dorzolamide
and brimonidine, however, even though more efficacious, latanoprost was not
cost effective compared to timolol. (William Hodge, Ottawa, Canada)
Lymphatic channels have been identified in the human ciliary body using
lymphatic cell specific molecular markers. Nano-sphere injection into the sheep
anterior chamber revealed a complex lymphatic system from the ciliary body to
sclera. This novel uveolymphatic pathway has implications for aqueous humor
drainage in glaucoma. (Neeru Gupta, Toronto, Canada)
Of 39 publications comparing the efficacy of topical prostaglandins, 29
(74%) were funded by industry. Twenty-eight percent of the industry-funded publications
had a statistically significant main outcome measure, however, 90% of the industry-funded
studies had a pro-industry abstract conclusion. Readers should carefully scrutinize
publications to ensure that data supports the authors' conclusions. (Tariq Alasbali,
Toronto, Canada)