cloprostenol and Ocular-Hypotension

Travoprost (isopropyl (Z)-7-[(1R,2R,3R,5S)-3,5-dihydroxy-2-[(1E,3R)-3-hydroxy-4-[alpha,alpha,alpha,trifluoro-m-tolyl)oxy]-1butenyl]cyclopentyl]-5-heptenoate) is an isopropyl ester prodrug and a high-affinity, selective FP prostaglandin- receptor full agonist. This prodrug is a synthetic prostaglandin analogue, which in appropriate cases is administered topically for the treatment of glaucoma and ocular hypertension. The isopropyl ester prodrug is rapidly hydrolyzed by esterases in the cornea to the biologically active, free acid. Travoprost has demonstrated preferential affinity and full agonist activity for the FP receptor in the nanomolar range, with no meaningful affinity or activity at other receptors. Like other compounds of this class, the reduction of intraocular pressure by travoprost is due at least in part to increased uveoscleral outflow. Results from phase II and phase III pivotal studies for FDA approval in the United States have demonstrated that travoprost is an effective topical agent for treatment of elevated intraocular pressure in patients with open-angle glaucoma and ocular hypertension. Travoprost is a safe drug, with local side effects including hyperemia, eyelash growth and iris color change. The dosing is once per day in the evening, and storage does not require refrigeration. Travoprost will be a helpful new drug in the medical management of glaucoma.

Topics: Animals; Clinical Trials as Topic; Cloprostenol; Humans; Ocular Hypotension; Travoprost

To compare intraocular pressure (IOP) lowering efficacy of bimatoprost 0.03% / timolol 0.5% fixed combination (BTFC) and other combinations of glaucoma drugs (bimatoprost, latanoprost 0.005% / timolol 0.5% fixed combination, separate use of travoprost 0.004 % and timolol 0.5 %) in patients with glaucoma.. Fifty-three patients with glaucoma were divided into 3 groups according to their original glaucoma therapy. BTFC was used by the patients for a period of 3 months. After 1 week, 1, 2 and 3 months, the diurnal IOP curves were performed. Side effects of the new treatment were recorded and compared to the original therapy.. The mean diurnal IOP reduction in the group of patients switching from bimatoprost to BTFK reached 4.4 +/- 2.28 mm Hg (p < 0.01). In the group of patients initially on latanoprost / timolol fixed combination, the IOP decreased with BTFK by 2.3 +/- 1.5 mm Hg (p < 0.01). Changing therapy from travoprost / timolol seperate combination to BTFK caused an IOP decrease by 2.3 +/- 1.5 mm Hg on average (p < 0.01). Conjunctival hyperemia with initial therapy was experienced in 33% of patients in our study group. With BTFK application, the hyperemia improved in 69% of these patients, got worse in 12.5% and remained unchanged in 19% of the patients. Patients found the BTFK better than the original medication in 37.5% of cases, the same in 52% and worse in 10.5%. Five patients terminated the study earlier due to poor IOP compensation or marked side effects of BTFK.. In all three groups of glaucoma patients there was a significant and prolonged decrease in IOP after treatment with BTFK. The use of BTFK was accompanied by smaller incidence of conjunctival hyperemia compared to isolated bimatoprost or travoprost / timolol combination.

Topics: Adult; Aged; Amides; Antihypertensive Agents; Bimatoprost; Cloprostenol; Drug Combinations; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Middle Aged; Ocular Hypotension; Prostaglandins F, Synthetic; Timolol; Travoprost

This study evaluated systemic and ocular acute safety and intraocular pressure (IOP)-lowering efficacy of travoprost 0.004% and bimatoprost 0.03%, compared to brimonidine 0.2% and betaxolol 0.25% in healthy subjects.. Nineteen (19) young men, ages between 24 and 42, were enrolled in a single-center, institutional randomized, double-masked, crossover clinical trial. Baseline IOP, heart rate, blood pressure, and respiratory rate were recorded at hour 0. At minute 30, heart rate, blood pressure, respiratory rate, and spirometry were measured. At hour 1, color Doppler imaging of retrobulbar vessels was performed. At hour 2, heart rate, blood pressure, and respiratory rate were measured; spirometry and a 15-minute treadmill test were performed. The same protocol was applied after one drop of a study medication was instilled into each eye on four subsequent visits at 5-day intervals.. Travoprost and bimatoprost did not cause significant reductions in systolic blood pressure during exercise and recovery. The mean respiratory rate and forced expiratory volume in 1 second were not significantly altered by any study medication. Travoprost reduced the resistive index and increased blood velocities in the ophthalmic artery and its branches. Bimatoprost caused a significant increase in end diastolic velocity of the ophthalmic artery. At hour 6, all medications reduced IOP significantly (p < 0.05). The most frequent ocular side effect of travoprost and bimatoprost was conjunctival hyperemia.. Travoprost and bimatoprost were found to be systemically safe and caused an increase in blood-flow velocities of the retrobulbar vessels after a single-dose application. Their ocular hypotensive effect was comparable to that of brimonidine and greater than that of betaxolol in healthy subjects.

Topics: Administration, Topical; Adult; Amides; Betaxolol; Bimatoprost; Brimonidine Tartrate; Cardiovascular System; Cloprostenol; Cross-Over Studies; Double-Blind Method; Eye; Humans; Intraocular Pressure; Lipids; Male; Ocular Hypotension; Prospective Studies; Pulmonary Circulation; Quinoxalines; Regional Blood Flow; Travoprost

Topics: Acetazolamide; Adolescent; Antihypertensive Agents; Ciliary Body; Clonidine; Cloprostenol; Combined Modality Therapy; Endotamponade; Eye Injuries, Penetrating; Humans; Hyaluronic Acid; Male; Microscopy, Acoustic; Ocular Hypotension; Retinal Diseases; Rupture; Tomography, Optical Coherence; Travoprost; Visual Acuity; Wounds, Gunshot

Topics: Antihypertensive Agents; Cloprostenol; Drug Combinations; Glaucoma; Humans; Latanoprost; Ocular Hypotension; Prostaglandins F, Synthetic; Timolol; Travoprost; Treatment Failure

Topics: Aged; Antihypertensive Agents; Choroid Diseases; Cloprostenol; Glaucoma; Humans; Intraocular Pressure; Male; Ocular Hypotension; Trabeculectomy; Travoprost

To report three cases of delayed choroidal detachment after treatment with topical prostaglandin analogs.. Intervention three case reports. Four eyes of three patients with chronic angle closure glaucoma developed choroidal detachment after using topical prostaglandin analogs.. Three patients with chronic angle closure glaucoma developed chroidal detachment in one week, three weeks and two years after using travoprost, bimatoprost and latanoprost respectively. All of them resolved after discontinuation of these medications. All of the eyes that developed chroidal detachment were pseudophakic.. Travoprost, bimatoprost and latanoprost may lead to choroidal detachment and hypotony. Pseudophakic patients may be at high risk of the development of chroidal detachment. Topical prostaglandin analogs should be used cautiously in these patients.

Topics: Administration, Topical; Aged; Amides; Bimatoprost; Choroid Diseases; Cloprostenol; Female; Glaucoma, Angle-Closure; Humans; Latanoprost; Lipids; Middle Aged; Ocular Hypotension; Prostaglandins F, Synthetic; Prostaglandins, Synthetic; Risk Factors; Time Factors; Travoprost