cloprostenol and Dry-Eye-Syndromes

Primary open-angle glaucoma (POAG), a chronic, degenerative optic neuropathy, requires persistent decrease of intraocular pressure so as to prevent visual impairment and blindness. However, long-term use of topical ocular medications may affect ocular surface health. Purpose of this study was to evaluate the influence of BAK-preserved prostaglandin analog treatment on the ocular surface health in patients with newly diagnosed POAG.. 40 newly diagnosed POAG patients were included in this prospective study. Intraocular pressure (IOP), tear break-up time (TBUT), and ocular surface disease index (OSDI) were assessed at baseline and 3-month after starting treatment with BAK-preserved travoprost 0.004%.. IOP decreased in all patients from baseline to 3-month final visit (23.80 ± 1.73 mmHg versus 16.78 ± 1.27 mmHg; P < 0.001). Mean TBUT decreased from 11.70 ± 1.86 seconds at baseline to 8.30 ± 1.29 seconds at 3-month final visit (<0.001). Mean OSDI score increased from 31.63 ± 18.48 to 44.41 ± 16.48 (P < 0.001).. This study showed that BAK-preserved travoprost 0.004% is an effective medication in newly diagnosed POAG patients, but its long-term use may negatively influence ocular surface health by disrupting the tear film stability. Further studies are needed to better understand the clinical effects of different preservative types and concentrations on the ocular surface.

Topics: Adult; Aged; Antihypertensive Agents; Cloprostenol; Croatia; Dry Eye Syndromes; Female; Glaucoma, Open-Angle; Humans; Male; Middle Aged; Ocular Hypertension; Preservatives, Pharmaceutical; Travoprost; Treatment Outcome

To investigate the clinical relevance of two different preservative formulations, we compared 1-year incidence rates of additional coding of dry eye, ocular infection, or ocular surface disease (either dry eye or ocular infection) in open-angle glaucoma and ocular hypertension patients newly treated with latanoprost with benzalkonium chloride (BAK) or with travoprost-Z with SofZia®.. This was a retrospective study of three U.S.-based patient-centric medical/pharmacy claims databases (MedStat, PharMetrics, i3-Ingenix). Patients were eligible if they filled a prescription for latanoprost or travoprost-Z between October 2006 and Q2 2008 (prescription date = index date) AND were continuously enrolled 6 months prior through 12 months after the index date AND had any open-angle glaucoma or ocular hypertension diagnosis within 90 days prior to the index date AND did not have an ocular surface disease diagnosis during the 180 days prior to the index date AND if they had not had a prescription for the index agent in the 180 days prior to the index date. Time to incidence of new coding for ocular surface disease in the first year post-index was estimated with a composite endpoint: diagnosis of dry eye or ocular infection by ICD-9-CM or Current Procedural Terminology code OR by prescription for cyclosporine ophthalmic emulsion or ocular antibiotics.. In all, 15,933 patients were treated with latanoprost and 7670 with travoprost-Z. Over 1 year, 4.3% of latanoprost and 4.5% of travoprost-Z patients were identified with dry eye (p = 0.28), and 10.9% and 11.1%, respectively, were identified with an ocular infection (p = 0.79). The 1-year incidence of new coding for ocular surface disease also was similar across treatments (13.9% vs 14.3%, respectively; p = 0.48).. The retrospective analysis of three large prescription databases revealed that open-angle glaucoma and ocular hypertension patients newly treated with latanoprost preserved with BAK or travoprost-Z preserved with SofZia did not differ statistically in rates of dry eye, ocular infection, or ocular surface disease (either dry eye or ocular infection) during the first year post-index. Claims-based analyses are limited by nonrandomization and the inability to account for over-the-counter use or samples.

Topics: Aged; Aged, 80 and over; Antihypertensive Agents; Benzalkonium Compounds; Cloprostenol; Current Procedural Terminology; Databases, Factual; Dry Eye Syndromes; Eye Infections; Female; Glaucoma, Open-Angle; Humans; International Classification of Diseases; Kaplan-Meier Estimate; Latanoprost; Male; Medicine; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Pharmacy; Prescriptions; Preservatives, Pharmaceutical; Prostaglandins F, Synthetic; Prostaglandins, Synthetic; Retrospective Studies; Travoprost

To determine the effects of travoprost 0.004% and latanoprost 0.005% treatment on ocular surface in primary open angle glaucoma (POAG) patients.. Clinical, observational prospective study, during 6 months on two groups of patients newly diagnosed with POAG. Group I (10 patients) was treated with travoprost 0.004% and group II (10 patients) was treated with latanoprost 0.005%. The groups were homogeneous about age and sex, exclusion criteria being any ocular or general associated pathology Routine ophthalmic examination was performed before and after treatment. At each examination was performed Schirmer 1 test and break up time test. Conjunctival cytology specimen was taken and goblet cells density evaluated.. There was statistically significant difference in goblet cell density Schirmer 1 test and BUT test before and after treatment (p<0.05). For the both groups the decrease of IOP was similar (from 23.7+/-1.5 mmHg to 15.4+/-1.7 mmHg in group I and from 24.3+/-1.5 mmHg to 15.8+/-1.7 mmHg in group II).. This study showed that travoprost 0.004% and latanoprost 0.005% treatment can have adverse effects on ocular surface and may give rise to dry eye symptoms.

Topics: Aged; Antihypertensive Agents; Case-Control Studies; Cloprostenol; Conjunctiva; Drug Therapy, Combination; Dry Eye Syndromes; Epithelium; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ophthalmic Solutions; Prospective Studies; Prostaglandins F, Synthetic; Travoprost