dinoprost and Exfoliation-Syndrome

Exfoliation syndrome is the most common identifiable cause leading to chronic open-angle glaucoma. It affects the treatment of glaucoma in various ways. The prognosis of capsular glaucoma (exfoliative glaucoma) is worse than that of open-angle glaucoma. Medical therapy and the long-term effect of laser treatment seem to be unsatisfactory in capsular glaucoma. Surgical intervention may be needed early, although eyes with exfoliation syndrome are prone to surgical complications. Finally, absolute glaucoma and blindness are more common in capsular glaucoma than in primary open-angle glaucoma. This article deals with the impact of exfoliation syndrome on therapeutic efficacy in open-angle glaucoma. It reviews the literature between October 1993 and September 1994; only a few studies concerning this important subject have been published during the given period.

Topics: Adrenergic alpha-Agonists; Dinoprost; Exfoliation Syndrome; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Laser Coagulation; Ophthalmic Solutions; Pilocarpine; Trabeculectomy

A long-term comparison of the ocular hypotensive efficacy and safety of unoprostone isopropyl 0.15% twice daily with that of timolol maleate 0.5% twice daily and betaxolol HCl 0.5% twice daily.. This was a randomized, multicenter, double-masked, active-controlled 24-month clinical trial involving 27 centers in Europe and Israel.. The study population was composed of patients with primary open-angle glaucoma (including pseudoexfoliation) or ocular hypertension. After washout of antiglaucoma medications, intraocular pressure (IOP) was measured at 0, + 2, + 8, and + 12 hours. Patients were randomized in a 2:1:1 ratio to unoprostone, timolol, or betaxolol. Patients returned for examinations at 2 and 6 weeks and 3 and 6 months.. 556 patients were randomized. Each drug produced a clinically and statistically (P <.001) significant reduction from baseline in 12-hour diurnal IOP at month 6 (- 4.3 mm Hg, unoprostone; - 5.8 mm Hg, timolol; - 4.9 mm Hg, betaxolol). Differences in adjusted treatment means between unoprostone and timolol and unoprostone and betaxolol were 1.57 mm Hg (95% CI: 1.00, 2.13) and 0.53 mm Hg (95% CI: - 0.03, 1.09), respectively. Unoprostone was clinically equivalent to betaxolol but did not have as great an IOP-lowering effect as timolol. Discontinued for inadequate control of IOP were 7%, 1%, and 4% of the patients for unoprostone, timolol, and betaxolol, respectively. There were no changes of note in visual acuity, pupil size, cup-to-disk ratio, visual fields, or iris color. Changes in heart rate and blood pressure were small, with no clinically significant differences between groups.. Unoprostone provided a clinically significant IOP-lowering effect equivalent to betaxolol but not to timolol. The side effect profile of unoprostone appears to be comparable to other established IOP-lowering agents.

Topics: Adrenergic beta-Antagonists; Antihypertensive Agents; Betaxolol; Dinoprost; Double-Blind Method; Exfoliation Syndrome; Female; Glaucoma, Open-Angle; Hemodynamics; Humans; Intraocular Pressure; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Pupil; Safety; Timolol; Visual Acuity; Visual Fields

Topics: Aged; Case-Control Studies; Cataract; Dinoprost; Exfoliation Syndrome; Female; Humans; Immunoenzyme Techniques; Male

The authors investigated the concentrations of 8-isoprostaglandin F(2a), a marker of oxidative stress in vivo, and ascorbic acid, a protectant against oxidative damage, in the aqueous humour of patients with exfoliation syndrome (XFS) and cataract and compared the results with those in age matched patients with cataract, but without XFS, to determine whether XFS is associated with increased oxidative stress.. Aqueous humour was aspirated at the beginning of phacoemulsification cataract surgery from 27 eyes of 27 cataract patients with XFS and 27 eyes of 27 age matched cataract patients without XFS. 8-Isoprostaglandin F(2a)concentration in the aqueous was determined with a commercial immunoassay; ascorbic acid concentration was measured with a microplate assay method.. The mean concentration of 8-isoprostaglandin F(2a)in the aqueous from patients with XFS (2429 (SD 2940) pg/ml; range 400-10500 pg/ml) was significantly higher than that measured in the aqueous of age matched control patients (529.1 (226.8) pg/ml; range 325-1000 pg/ml); (p = 0.0028). Furthermore, mean ascorbic acid concentration in XFS patients (0.75 (0.39) mM; range 0.28-1.70 mM) was significantly lower than that found in control patients (1.19 (0.47) mM; range 0.53-2.4 mM); (p = 0.0005). There was a reverse correlation between 8-isoprostaglandin F(2a)and ascorbic acid concentration.. 8-Isoprostaglandin F(2a)was significantly increased in the aqueous of patients with XFS, and ascorbic acid was decreased, providing evidence of a role for free radical induced oxidative damage in the pathobiology of XFS.

Topics: Antioxidants; Aqueous Humor; Ascorbic Acid; Cataract; Dinoprost; Exfoliation Syndrome; F2-Isoprostanes; Free Radical Scavengers; Humans; Immunoassay; Oxidative Stress; Prospective Studies

The purpose of this study is to evaluate the effect of the PGF2alpha isopropyl ester analogue, Latanoprost which is a new ocular hypotensive topical agent, on the aqueous humor PGF2alpha levels in open-angle glaucoma patients.. Patients diagnosed with either capsular or primary open-angle glaucoma and scheduled for trabeculectomy, were consecutively enrolled in the study. Group 1 represented the control group (n = 17) and Group 2 represented the Latanoprost treatment group (n = 9). All the topical drugs were stopped 10 days preoperatively and only systemic carbonic anhydrase inhibitors were continued if necessary. Group 2 patients received topical 0.005% Latanoprost once daily for 5-10 days preoperatively. During trabeculectomy operation, aqueous samples were taken through paracentesis from the patients. Aqueous humor levels of PGF2alpha and its metabolite 13,14-dihydro-15-keto-PGF2alpha were measured using enzyme-immunoassay.. The mean PGF2alpha levels were 24.38 +/- 5.79 pg/ml in the control group and 10.99 +/- 4.11 pg/ml in the Latanoprost group, the difference of which was statistically significant (p < 0.05). In the Latanoprost group, there was a positive correlation between levels of PGF2alpha, and its metabolite (p < 0.05).. Pretreatment with PGF2alpha isopropyl ester analogue, Latanoprost topically decreased PGF2alpha levels in the aqueous humor of glaucomatous eyes, probably due to its uveoscleral outflow increasing effect. The clinical importance and application of this result has to be determined.

Topics: Aged; Antihypertensive Agents; Aqueous Humor; Biomarkers; Blood-Aqueous Barrier; Dinoprost; Dinoprostone; Exfoliation Syndrome; Female; Glaucoma, Open-Angle; Humans; Immunoenzyme Techniques; Intraocular Pressure; Latanoprost; Male; Ophthalmic Solutions; Prostaglandins F, Synthetic; Trabeculectomy

Topics: Dinoprost; Epinephrine; Exfoliation Syndrome; Humans; Iris; Laser Therapy; Miotics; Retinal Detachment