dorzolamide-timolol-combination and Low-Tension-Glaucoma

To assess the noninferiority of a dorzolamide-timolol fixed combination (DTFC) versus latanoprost in terms of intraocular pressure (IOP) and to compare blood pressure (BP), ocular perfusion pressure (OPP) and diastolic ocular perfusion pressure (DOPP) between the latanoprost and DTFC groups in patients with normal-tension glaucoma (NTG).. Prospective, interventional, randomized, single-blinded, crossover design study. Patients with newly diagnosed NTG that had not been treated with a glaucoma medication in the most recent 2 months were recruited. In total, 44 patients with NTG were randomly allocated to one of two groups. Patients in group A were treated with DTFC, lubricant, and latanoprost for 4 weeks each, whereas patients in group B were treated with latanoprost, lubricant, and DTFC for 4 weeks each. Patients were examined on day 1 (without medication), week 4 (under medication), week 8 (without medication), and week 12 (under medication). At weeks 4 and 12, diurnal IOP, systolic and diastolic BP, and OPP were measured at 8:00 AM, 10:00 AM, 12:00 PM, 4:00 PM, and 8:00 PM.. Baseline demographic characteristics showed no difference in terms of age, sex, central corneal thickness, spherical equivalent, or stage of glaucoma between the groups. The between-group difference was -0.19 ± 0.18 mmHg (mean ± SE, upper bound of one-sided 95% CI, 0.12). Diurnal IOP showed no difference between the groups with an average IOP reduction of 13.1% using latanoprost and 12.3% using DTFC. Diurnal systolic and diastolic BP were lower in the DTFC group than the latanoprost group; however, the difference between the groups was not statistically significant. Diurnal OPP and DOPP also showed no statistically significant difference between the groups.. IOP lowering efficacy of DTFC was noninferior to that of latanoprost in newly diagnosed NTG patients. There was no difference in BP, OPP, or DOPP between the latanoprost and DTFC groups. This prospective, randomized, single-blinded, crossover study demonstrated the noninferiority of DTFC versus latanoprost in terms of IOP in patients with NTG.. ClinicalTrials.gov NCT01175902.

Topics: Blood Pressure; Circadian Rhythm; Cross-Over Studies; Demography; Diastole; Drug Combinations; Female; Heart Rate; Humans; Intraocular Pressure; Latanoprost; Low Tension Glaucoma; Male; Middle Aged; Perfusion; Prostaglandins F, Synthetic; Sulfonamides; Systole; Thiophenes; Timolol

To compare the efficacy and tolerability of brinzolamide/timolol (BT) and dorzolamide/timolol (DT) fixed combinations on intraocular pressure (IOP) reduction.. Patients with primary open angle glaucoma or normal tension glaucoma were randomized to receive either BT or DT. IOPs were measured at baseline, 2 weeks, and 1, 2, and 3 months. The primary outcome measures were the mean change in IOP from baseline at each visit. Secondary outcome measures included the tolerability of each fixed combination.. Seventy-three patients (73 eyes) were included; 37 eyes in BT group and 36 eyes in DT group. Baseline mean IOP were 24.14 ± 4.5 and 29.53 ± 6 mmHg for BT and DT, respectively (P < 0.001). Both BT and DT provided statistically significant mean IOP reductions from baseline values within each group at all study visits (P < 0.001). DT provided greater mean IOP reductions from baseline than BT at each visit which was statistically significant at 2 weeks (P = 0.037). Mean percentage of IOP reduction was 24.35% and 46.33% at 2 weeks (P < 0.001), and 24.65% and 47% at 3 months (P < 0.001) for BT and DT, respectively. Patients' tolerability appeared to be better for DT than for BT with complete ocular comfort without any ocular adverse effects in 31 patients (81.1%) in DT group and 11 patients (29.7%) in BT group (P < 0.001).. Both drops provide effective IOP reduction which was greater, and patients were more likely to achieve lower target pressures with DT than with BT.

Topics: Administration, Topical; Adolescent; Adult; Aged; Antihypertensive Agents; Carbonic Anhydrase Inhibitors; Drug Combinations; Egypt; Female; Glaucoma, Open-Angle; Hospitals, University; Humans; Intraocular Pressure; Low Tension Glaucoma; Male; Middle Aged; Ophthalmic Solutions; Prospective Studies; Sulfonamides; Thiazines; Thiophenes; Timolol; Tonometry, Ocular

The aim of this study was to evaluate the effects of a dorzolamide-timolol fixed combination (DTFC) on intraocular pressure (IOP), heart rate (HR), blood pressure (BP), ocular perfusion pressure (OPP), and diastolic ocular perfusion pressure (DOPP) in patients with normal-tension glaucoma (NTG).. A prospective, interventional, single-blind, single-center study was conducted. Newly diagnosed NTG patients that had not been treated with a glaucoma medication in the most recent 4 weeks were included. Patients were examined at baseline (without medication) and week 4 (under medication). Baseline IOP, HR, systolic and diastolic BP, OPP, and DOPP were measured at 8 am, 12 pm, and 4 pm. At week 4, IOP, HR, systolic and diastolic BP, OPP, and DOPP were measured at 10 am and 8 pm as well.. After 4 weeks of DTFC treatment, IOP was significantly reduced at all time points (1.6-2.6 mmHg, P < 0.001), and the average IOP reduction was 14.4 %. HR and systolic BP showed no statistically significant difference at all time points; however, diastolic BP was decreased significantly at 12 pm and 4 pm (P = 0.004 and 0.001). OPP and DOPP showed no statistical significant difference after DTFC.. DTFC has favorable effects on IOP and can be used without concerns of DOPP in patients with NTG.

Topics: Aged; Blood Pressure; Circadian Rhythm; Dose-Response Relationship, Drug; Drug Combinations; Female; Follow-Up Studies; Gonioscopy; Heart Rate; Humans; Intraocular Pressure; Low Tension Glaucoma; Male; Middle Aged; Ophthalmic Solutions; Prospective Studies; Single-Blind Method; Sulfonamides; Thiophenes; Time Factors; Timolol

To compare the ocular pulse amplitude (OPA) lowering effects of preservative-free tafluprost and dorzolamide-timolol fixed combination (DTFC) using dynamic contour tonometry.. In total, 66 eyes of 66 patients with normal tension glaucoma (NTG) (n = 34) or primary open angle glaucoma (POAG) (n = 32) were included. Patients were divided into two groups: the preservative-free tafluprost-treated group (n = 33) and the preservative-free DTFC-treated group (n = 33). Intraocular pressure (IOP) was measured using Goldmann applanation tonometry (GAT). OPA was measured using dynamic contour tonometry; corrected OPA (cOPA) was calculated at baseline and at 1 week and 1, 3, and 6 months after treatment.. After 6 months of treatment, tafluprost significantly reduced IOP (P < 0.001). The OPA lowering effects differed significantly between the two treatment groups (P = 0.003). The cOPA-lowering effect of tafluprost (1.09 mmHg) was significantly greater than that of DTFC (0.36 mmHg) after 6 months of treatment (P = 0.01).. Tafluprost and DTFC glaucoma treatments provided marked OPA and IOP lowering effects. Tafluprost had a greater effect than DTFC; thus, this drug is recommended for patients at risk of glaucoma progression, due to the high OPA caused by large fluctuations in IOP.

Topics: Drug Combinations; Eye; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Low Tension Glaucoma; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Preservatives, Pharmaceutical; Prostaglandins F; Retrospective Studies; Sulfonamides; Thiophenes; Timolol; Tonometry, Ocular