ganfort and Glaucoma--Open-Angle

A new preservative-free fixed-dose combination of 0.0015% tafluprost, a prostaglandin F2α analog, and 0.5% timolol (TAF/TIM; Santen Oy, Tampere, Finland), a beta-adrenergic antagonist has recently been developed. The intraocular pressure (IOP) reduction with TAF/TIM in open-angle glaucoma and ocular hypertension is similar to that of other prostaglandin-timolol fixed-combination products. Patients with high IOP responded well to TAF/TIM with reductions of up to 40% (>13 mmHg) and beyond. Compared to previous controlled and double-masked clinical trials with DuoTrav(®) (Alcon, Fort Worth, USA) and Ganfort(®) (Allergan, Irvine, USA), TAF/TIM caused less superficial ocular side effects and less conjunctival hyperemia. Plausible explanations for the differences in side effects between the fixed-combination products are discussed.

Topics: Adrenergic beta-Antagonists; Amides; Cloprostenol; Double-Blind Method; Drug Combinations; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Ocular Hypertension; Preservatives, Pharmaceutical; Prostaglandins F; Randomized Controlled Trials as Topic; Timolol

Modern fixed-combination products simplify medication dose regimen without sacrificing their effectiveness.Potential benefits of the therapy with fixed-combination products are enhanced tolerability increased convenience,better compliance,cost and time economy and removal of the wash out effect. Regarding intraocular pressure lowering effect, fixed-combination agents are superior to monotherapy with the two medication components, with the exception of Duotrav that is not superior to travoprost action.Fixed-combination products are noninferior to concomitant administration of the two components of medication (nonfixed-combination agents) relative to their ocular hypotensive efficacy with the exception of Ganfort that is however inferior to concurrent administration of both the bimatoprost and timolol.

Topics: Amides; Antihypertensive Agents; Bimatoprost; Brimonidine Tartrate, Timolol Maleate Drug Combination; Carbonic Anhydrase Inhibitors; Cloprostenol; Drug Combinations; Drug Therapy, Combination; Glaucoma; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Ophthalmic Solutions; Prostaglandins F, Synthetic; Quinoxalines; Sulfonamides; Thiazines; Thiophenes; Timolol; Travoprost; Treatment Outcome

To compare the efficacy and safety of single-dose bimatoprost 0.03%/timolol 0.5% preservative-free (PF) ophthalmic solution with bimatoprost 0.03%/timolol 0.5% ophthalmic solution in patients with open-angle glaucoma or ocular hypertension.. In this multicentre, randomised, parallel-group study, patients were randomised to bimatoprost/timolol PF or bimatoprost/timolol once daily in the morning for 12 weeks. Primary efficacy endpoints, reflecting differing regional regulatory requirements, included change from baseline in worse eye intraocular pressure (IOP) in the per-protocol population at week 12, and the average eye IOP at weeks 2, 6 and 12 in the intent-to-treat population.. 561 patients were randomised (278 to bimatoprost/timolol PF; 283 to bimatoprost/timolol); 96.3% completed the study. Both treatment groups showed statistically and clinically significant mean decreases from baseline in worse eye IOP and in average eye IOP at all follow-up time points (p<0.001). Bimatoprost/timolol PF met all pre-established criteria for non-inferiority and equivalence to bimatoprost/timolol. Ocular adverse events were similar between treatment groups, with conjunctival hyperaemia being the most frequent. Most were mild or moderate in severity.. Bimatoprost/timolol PF demonstrated non-inferiority and equivalence in IOP lowering compared with bimatoprost/timolol, with no significant differences in safety and tolerability.. NCT01177098.

Topics: Adult; Aged; Aged, 80 and over; Amides; Antihypertensive Agents; Cloprostenol; Double-Blind Method; Drug Combinations; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Preservatives, Pharmaceutical; Therapeutic Equivalency; Timolol; Tonometry, Ocular; Treatment Outcome; Young Adult

Selective laser trabeculoplasty (SLT) is an effective treatment to treat open-angle glaucoma with a low risk of complications. The case is presented of a 73 year-old woman with uncontrolled primary open-angle glaucoma who underwent selective laser trabeculoplasty in both eyes and developed bilateral choroidal effusion.

Topics: Aged; Amides; Brimonidine Tartrate; Choroid Diseases; Cloprostenol; Combined Modality Therapy; Drug Combinations; Emergencies; Exudates and Transudates; Female; Glaucoma, Open-Angle; Humans; Laser Therapy; Timolol; Trabeculectomy

Ganfort eye drops are indicated for adult patients with open-angle glaucoma who have poor response to topical β-blockers or prostaglandin analogues. They contain 0.3 mg of bimatoprost (a prostaglandin) and 5 mg of timolol (β-blocker). The authors present a case of a 45-year-old man with glaucoma presenting with shortness of breath. On admission, he had a normal heart rate, pulse oximetry and examination. Despite being of low risk stratification using the Wells score and the Modified Geneva Score for pulmonary emboli, CT pulmonary angiogram scan subsequently showed extensive bilateral multiple large pulmonary emboli. This case demonstrates that the systemic absorption of ocular β blockers is extremely high and it bypasses the first pass metabolism. Therefore, even one drop of Ganfort into each eye once a day was sufficient to disguise the tachycardia of a large pulmonary emboli.

Topics: Amides; Anticoagulants; Cloprostenol; Drug Combinations; Dyspnea; Glaucoma, Open-Angle; Heart Rate; Humans; Male; Middle Aged; Ophthalmic Solutions; Pulmonary Embolism; Radiography; Tachycardia; Timolol