latanoprost and Chronic-Disease

To provide a synopsis of primary angle closure disease in India, and Indian studies on the same.. Primary angle closure glaucoma forms almost half of all adult primary glaucomas seen in a hospital setting in India. Anatomically, corneal diameters and anterior chamber depths were least in acute and chronic PACG eyes as compared to subacute eyes and controls. Besides relative pupillary block, a Valsalva maneuver during activities of daily living may be responsible for intermittent angle closure and raised IOP in predisposed eyes. Iridotomy alone, controlled the intraocular pressure in 66.7% of subacute eyes and 12.9% of the acute. Medical therapy was additionally required for 35.5% of the acute eyes, 12.1% of the subacute and 30.0% of the chronic cases. There was a greater mean and peak IOP reduction, achieved with 0.005% latanoprost once daily, 8.2 ± 2.0 mm Hg, compared with 0.5% timolol twice daily, 6.1 ± 1.7 mm Hg2. A progression of PACS to PAC was seen in 22%, PAC to PAC OHT in 38.7% and PAC OHT to PACG in 30.7% over 5 years.. Primary angle closure disease is common in India, and can be managed well with iridotomy, followed by an appropriate control of IOP.

Topics: Acute Disease; Anterior Chamber; Antihypertensive Agents; Chronic Disease; Cornea; Disease Progression; Drug Administration Schedule; Glaucoma, Angle-Closure; Humans; Incidence; India; Iris; Latanoprost; Ocular Hypertension; Ophthalmologic Surgical Procedures; Prevalence; Prostaglandins F, Synthetic; Timolol

To assess the effect of switching 1 eye to topical travoprost 0.004% preserved with SofZia (TRAVATAN Z solution) in patients who had chronic superficial punctate keratitis (SPK) in both eyes treated with benzalkonium chloride-preserved latanoprost 0.005% (XALATAN).. This was a prospective, randomized, controlled, multicenter, open-label, comparative 3-month follow-up study. Patients with open-angle glaucoma or ocular hypertension who received XALATAN monotherapy for at least 3 months and had SPK in both eyes were enrolled at 9 facilities. For each patient, 1 eye was randomly selected and switched to TRAVATAN Z solution (T-group); the contralateral control eye was treated with XALATAN (X-group). SPK in 5 corneal regions, conjunctival hyperemia, tear breakup time (TBUT), and intraocular pressure (IOP) were examined in a masked manner at baseline, 1 month, and 3 months. Changes in SPK, hyperemia, TBUT, and IOP were compared within treatment groups and between treatment groups.. Fifty-six patients completed the study. The frequency of SPK significantly decreased from baseline in the T-group and the X-group at 1 and 3 months (T-group, P<0.001; X-group, P<0.05). In the T-group, SPK scores were significantly improved in 4 corneal regions, excluding the superior region, at 1 and 3 months (all P<0.05), whereas in the X-group, SPK scores were significantly improved only in the temporal region at 1 month and in the inferior region at 3 months (P<0.05 for both). The total SPK score at 1 and 3 months in the T-group was significantly lower compared with the score in the X-group (P=0.0023 and 0.0102, respectively). The SPK score for the superior and central corneal region at 3 months in the T-group was significantly lower compared with the score in the X-group (P=0.0212 and 0.022, respectively). There were no substantial intergroup or intragroup differences in changes from baseline for hyperemia scores, TBUT, or IOP reduction.. Switching therapy from benzalkonium chloride-preserved latanoprost to travoprost preserved with SofZia ameliorated chronic SPK. There were no clinically relevant changes in hyperemia, TBUT, or IOP.

Topics: Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Chronic Disease; Cornea; Dose-Response Relationship, Drug; Drug Substitution; Female; Follow-Up Studies; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Keratitis; Latanoprost; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Preservatives, Pharmaceutical; Prospective Studies; Prostaglandins F, Synthetic; Tonometry, Ocular; Travoprost

To compare the efficacy and safety of latanoprost and timolol in Chinese patients with chronic angle-closure glaucoma (CACG), who had undergone laser or surgical peripheral iridotomy but who continued to experience elevated intraocular pressure (IOP) levels.. This 8-week, randomized, open-label, parallel, active-controlled study was conducted at 4 sites in China. Subjects were 18 to 75 years of age; had primary, unilateral, or bilateral CACG with an IOP between 21 and 35 mm Hg inclusive at screening; and had undergone peripheral iridotomy at least 1 month before study entry. Subjects were randomized (1:1) to receive 1 drop of latanoprost 0.005% (PM) or 1 drop of timolol 0.5% twice daily (AM and PM). Follow-up was at weeks 1, 2, 4, and 8. Primary efficacy endpoint: change in average IOP from baseline to week 8.. One hundred forty-two subjects were randomized into the latanoprost and timolol group; the analysis population included 141 subjects (latanoprost, n=71; timolol, n=70). Mean baseline average IOP levels were 24 mm Hg in both groups. The least square mean change from baseline to week 8 was -6.7 mm Hg for latanoprost versus -4.9 mm Hg for timolol [least square mean difference=1.8 mm Hg (95% confidence interval, 0.7-2.9); P<0.001]. Latanoprost was associated with significantly lower mean average IOP levels at each visit (P<0.05). Both treatments were well tolerated and no treatment-emergent adverse event was considered by investigators to be severe.. Once-daily administration of latanoprost 0.005% was significantly more effective in reducing IOP in Chinese patients with CACG than twice-daily instillation of timolol 0.5%. Both agents were well tolerated.

Topics: Adolescent; Adult; Aged; Antihypertensive Agents; Asian People; China; Chronic Disease; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Prostaglandins F, Synthetic; Timolol; Treatment Outcome; Young Adult

The aim of this study was to compare the intraocular pressure (IOP)-lowering effect of latanoprost and bimatoprost as primary therapy in patients with chronic angle-closure glaucoma (CACG) after peripheral iridotomy.. Eighty-two (82) consecutive CACG patients with an IOP greater than 19 mmHg after a peripheral iridotomy were recruited. CACG was defined as chronic elevated IOP, glaucomatous optic neuropathy, and a corresponding visual field defect in eyes with occludable angle and peripheral anterior synechiae on gonioscopy. Patients were randomly assigned to two groups based on daily treatment with either latanoprost 0.005% or bimatoprost 0.03% in the evening for 12 weeks. The IOP was measured at 9 AM and 4 PM on the same day at baseline and also at 4, 8, and 12 weeks. Between-group differences in mean diurnal IOP and IOP reduction were analyzed.. After 12 weeks of treatment, mean IOP for both the latanoprost and bimatoprost groups was significantly reduced when compared to the baseline value (21.6 +/- 1.9 to 16.4 +/- 2.5 mmHg and 22.1 +/- 2.0 to 16.9 +/- 2.4 mmHg, respectively; P < 0.001 for both). There was no significant difference in IOP reduction between the two treatment groups (P = 0.40). At 4 and 8 weeks, the IOP changes from baseline were statistically significant at both times for both drugs (all P < 0.001).. Both latanoprost and bimatoprost significantly reduced IOP in CACG patients who were inadequately treated by laser peripheral iridotomy.

Topics: Aged; Aged, 80 and over; Amides; Antihypertensive Agents; Bimatoprost; Chronic Disease; Cloprostenol; Female; Follow-Up Studies; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Iridectomy; Laser Therapy; Latanoprost; Lipids; Male; Middle Aged; Prospective Studies; Prostaglandins F, Synthetic; Treatment Outcome

The aim of this study was to compare the intraocular pressure (IOP)-lowering effect of latanoprost and travoprost as primary therapy in patients with chronic angle-closure glaucoma (CACG) after peripheral iridotomy.. Seventy-three (73) CACG patients with IOP>19 mmHg after peripheral iridotomy and without previous antiglaucoma medication were consecutively recruited. CACG was defined as the presence of chronically elevated IOP, glaucomatous optic neuropathy, and a corresponding visual field defect in eyes with occludable angle and peripheral anterior synechiae on gonioscopy. Patients were randomly assigned to 2 groups, based on daily treatment with either latanoprost 0.005% or travoprost 0.004% in the evening for 12 weeks. The IOP was measured at 9 AM and 4 PM at baseline and at 4, 8, and 12 weeks. Between-group differences in mean diurnal IOP and IOP reduction were analyzed.. After 12 weeks of treatment, mean IOP for both the latanoprost and travoprost groups was significantly reduced, when compared to the baseline IOP (from 21.3+/-1.8 mmHg to 16.0+/-2.3 mmHg and 21.7+/-1.7 to 16.7+/-2.2 mmHg; P<0.001 for both). There was no significant difference in IOP reduction between the 2 treatment groups (P=0.19). At 4 and 8 weeks, the IOP changes from the baseline were statistically significant at all time points for both drugs (all P<0.001).. Both latanoprost and travoprost significantly reduced IOP in our sample of CACG patients after peripheral iridotomy.

Topics: Aged; Antihypertensive Agents; Chronic Disease; Cloprostenol; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Iridectomy; Laser Therapy; Latanoprost; Male; Prospective Studies; Prostaglandins F, Synthetic; Travoprost; Treatment Outcome

To investigate the relationship between drainage angle configuration with untreated intraocular pressure (IOP) and optic disc cupping in subjects with chronic angle-closure glaucoma (CACG).. Prospective, observational study.. Two hundred seventy-five Asian subjects with CACG who participated in a randomized controlled trial that investigated the IOP-reducing effect of latanoprost and timolol.. Chronic angle-closure glaucoma was defined as the presence of glaucomatous optic neuropathy (with or without a visual field defect), an anterior chamber angle in which the pigmented trabecular meshwork was not visible for at least 180 degrees on gonioscopy, and evidence of peripheral anterior synechiae (PAS) in association with elevated IOP of 21 mmHg or more. Static and dynamic gonioscopy were performed, the angles were graded in each quadrant according to the Shaffer scheme, and the number of clock hours of PAS was recorded. The untreated IOP and vertical cup-to-disc ratio were correlated with mean angle width and extent of PAS.. Mean angle width, clock hours of PAS, IOP, and vertical cup-to-disc ratio.. Most subjects were female (75%), and the mean age was 62.9+/-9.4 years. The mean angle width was 0.77+/-0.53 and the mean number of clock hours of PAS was 4.77+/-3.2 hours. Untreated IOP correlated with angle width (r = -0.23; P<0.001) and clock hours of PAS (r = 0.22; P<0.001). Vertical cup-to-disc ratio also correlated with angle width (r = -0.17; P = 0.004) and PAS (r = 0.28; P<0.001). Performing a multiple linear regression using baseline IOP as the outcome variable with age, gender, clock hours of PAS, and angle width as predictors, there was a 0.39-mmHg (95% confidence interval, 0.15-0.63) increase in baseline untreated IOP for each unit increase in clock hours of PAS (P = 0.002).. In subjects with CACG, the extent of PAS and a narrower width of the drainage angle were associated with higher untreated IOP and a larger vertical cup-to-disc ratio.

Topics: Adult; Aged; Aged, 80 and over; Anterior Chamber; Antihypertensive Agents; Aqueous Humor; Chronic Disease; Female; Glaucoma, Angle-Closure; Gonioscopy; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Optic Disk; Optic Nerve Diseases; Prospective Studies; Prostaglandins F, Synthetic; Timolol; Trabecular Meshwork

To examine the relationship between the configuration of the drainage angle and intraocular pressure (IOP)-lowering efficacy of latanoprost in subjects with chronic angle-closure glaucoma (CACG).. Prospective observational case series.. One hundred thirty-seven Asian subjects with CACG.. Study subjects had participated in a 12-week, randomized, double-masked study that assessed the IOP-reducing effect of latanoprost. Chronic angle-closure glaucoma was defined as optic neuropathy with or without a visual field defect, an anterior chamber angle in which the trabecular meshwork was not visible for at least 180 degrees on gonioscopy, and evidence of peripheral anterior synechiae (PAS) in association with a chronically elevated IOP. Static and dynamic gonioscopy was performed at baseline. The angles were graded in each quadrant according to the Shaffer scheme, and the number of clock hours of PAS was recorded. The change in daily IOP (defined as the mean of the 9:00 am and 5:00 pm IOP time point values) from baseline to week 12 was analyzed and correlated with mean angle width and extent of PAS.. One hundred thirty-seven Asian subjects with CACG completed the study in the latanoprost-treated group. Most subjects were female (75%), and the mean age was 62.6+/-9.4 years. At baseline, the mean angle width was 0.84+/-0.55, and the mean number of clock hours of PAS was 4.67+/-2.95. After 12 weeks of treatment, latanoprost reduced IOP from 25.0+/-5.5 mmHg to 17.5+/-5.0 mmHg (P<0.001). The percent change in IOP produced by latanoprost was not associated with mean angle width (Spearman's r = 0.04, P = 0.64) or the number of clock hours of PAS (Spearman's r = -0.15, P = 0.08).. In subjects with CACG, the IOP-reducing efficacy of latanoprost was not affected by the degree of angle narrowing or extent of synechial angle closure.

Topics: Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Chronic Disease; Double-Blind Method; Female; Glaucoma, Angle-Closure; Gonioscopy; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ophthalmic Solutions; Prospective Studies; Prostaglandins F, Synthetic; Timolol; Trabecular Meshwork

To compare the efficacy, adverse effects, and patient compliance of latanoprost monotherapy with unfixed combination therapy with 0.5% timolol maleate and 1% dorzolamide in the treatment of chronic primary angle-closure glaucoma (CACG), 36 Japanese patients with CACG following laser iridotomy (LPI) were treated for 12 weeks with instillation of latanoprost alone or with unfixed combination therapy of 0.5% timolol maleate and 1% dorzolamide hydrochloride. After 12 weeks of treatment, latanoprost reduced intraocular pressure (IOP) from 22.2 +/- 2.0 mmHg to 14.8 +/- 1.9 mmHg (33% reduction); timolol maleate and dorzolamide hydrochloride also reduced IOP from 22.5 +/- 2.2 mmHg to 17.1 +/- 2.7 mmHg (24% reduction). Latanoprost monotherapy significantly lowered IOP compared with unfixed combination therapy of 0.5% timolol maleate and 1% dorzolamide hydrochloride. Furthermore, a systemic adverse effect of bradycardia was not observed in the latanoprost monotherapy group. Concerning compliance, no significant difference was observed between the two groups. Thus, latanoprost monotherapy is more effective than unfixed combination therapy with 0.5% timolol maleate and 1% dorzolamide in the treatment of CACG following relief of pupillary block in Japanese patients.

Topics: Aged; Antihypertensive Agents; Chronic Disease; Drug Combinations; Female; Glaucoma, Angle-Closure; Humans; Instillation, Drug; Intraocular Pressure; Japan; Latanoprost; Male; Ophthalmic Solutions; Patient Compliance; Prostaglandins F, Synthetic; Sulfonamides; Thiophenes; Timolol

To compare latanoprost and timolol maleate as primary therapy in 60 eyes with chronic primary angle-closure glaucoma after a laser iridotomy.. We performed a prospective, randomized, crossover study of 60 eyes of 30 patients with chronic primary angle-closure glaucoma after laser iridotomy. Patients were randomized to 2 groups: those taking latanoprost once daily or those taking timolol twice daily. Three months after treatment with the first drug, the second drug was substituted. The circadian rhythm of intraocular pressure (IOP) was recorded before the start of therapy, at 3 months, and at 7 months. The fourth month was the washout period for the first drug.. The mean baseline IOP was 23.5 +/- 2.1 mm Hg, which decreased by 8.2 +/- 2.0 mm Hg with latanoprost (P<.001) and by 6.1 +/- 1.7 mm Hg with timolol (P =.01). The decrease in IOP was greater for patients taking latanoprost (P<.001). Latanoprost was significantly more effective in eyes having morning and afternoon peaks of IOP. A total of 43 eyes (72%) of patients taking latanoprost and 26 (43%) on timolol achieved a reduction of more than 30% from baseline IOP.. There were greater mean and peak IOP reductions achieved with 0.005% latanoprost once daily compared with 0.5% timolol twice daily.

Topics: Aged; Antihypertensive Agents; Chronic Disease; Circadian Rhythm; Cross-Over Studies; Double-Blind Method; Drug Administration Schedule; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Iridectomy; Latanoprost; Male; Middle Aged; Ophthalmic Solutions; Prospective Studies; Prostaglandins F, Synthetic; Timolol

To demonstrate that the intraocular pressure (IOP)-reducing effect of latanoprost once daily is at least as good as that of timolol twice daily in patients with chronic angle-closure glaucoma (CACG).. Randomized, double-masked, multicenter 12-week study.. In all, 137 patients with unilateral or bilateral CACG were treated with latanoprost, and 138 were treated with timolol.. Patients received either latanoprost (9 pm) and a placebo (9 am) or timolol (both 9 am and 9 pm). Intraocular pressure was measured at 9 am and 5 pm at baseline and weeks 2, 6, and 12.. The difference between groups in daily IOP (average of 9 am and 5 pm measures) reduction was the primary outcome. Secondary outcomes included differences between groups in IOP reductions at 9 am and 5 pm, and in proportions of patients reaching specified daily IOP levels.. Using repeated measures (analysis of covariance: intent to treat), mean changes from baseline in daily IOP levels during 12 weeks were -8.2 mmHg and -5.2 mmHg for latanoprost- and timolol-treated patients, respectively (difference: -3.0 mmHg [95% confidence interval: -4.0, -2.1], P<0.001). Greater reductions in IOP levels at both 9 am and 5 pm were found in latanoprost-treated patients (P<0.001 for both), and greater proportions of patients receiving latanoprost reached prespecified target daily IOP levels (P<0.001 for all 3 target levels tested). Both drugs were well tolerated.. Latanoprost administered once daily provides significantly greater IOP reduction in CACG patients than does timolol instilled twice daily.

Topics: Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Chronic Disease; Double-Blind Method; Drug Administration Schedule; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Prostaglandins F, Synthetic; Timolol

To compare the tolerance and peak intraocular pressure (IOP)-lowering efficacy of brimonidine and latanoprost as adjunctive therapy in patients with ocular hypertension or glaucoma uncontrolled on beta-blockers.. A prospective, multicenter, double-masked, parallel-design clinical trial.. One hundred fifteen patients with IOP inadequately controlled on topical beta-blocker monotherapy.. Patients were randomly assigned to receive brimonidine, 0.2%, twice a day or latanoprost, 0.005%, every day as adjunctive therapy for 3 months. After 1 month of adjunctive treatment, patients who failed to meet a target 15% reduction in IOP at peak drug effect were crossed over to the other study medication. The target sample size of 51/group gave a power of 0.80 to detect a difference of 1 mmHg in mean IOP lowering between groups.. The primary outcome variables were reduction in IOP from baseline at peak drug effect, response rate, and quality of life as measured using the Glaucoma Disability Index.. Mean beta-blocker-treated baseline IOP was comparable between treatment groups (approximately 21.3 mm Hg). After 1 month of adjunctive therapy, brimonidine and latanoprost provided comparable IOP lowering (4.88 mmHg [22.8%] with brimonidine and 5.01 mmHg [23.5%] with latanoprost, P = 0.798). Response rates were similar in both groups, with 44 of 54 brimonidine patients and 43 of 53 latanoprost patients achieving the minimum target 15% IOP reduction at peak drug effect at month 1 (P = 0.963). Among patients who were successful at month 1 and continued on the initial study medication, mean IOP reductions were 4.55 mmHg with brimonidine and 5.49 mmHg with latanoprost (P = 0.149) at month 3. There was no significant difference in the ability of brimonidine and latanoprost to maintain at least a 15% additional reduction in IOP for 3 months (28 of 38 patients on brimonidine vs. 30 of 36 patients on latanoprost achieved > or =15% IOP reduction at month 3; P = 0.314). Patients in the latanoprost group were more likely to report negative quality-of-life variables than patients in the brimonidine group. Significantly more latanoprost patients reported watery or teary eyes (34 of 53, 64.2% vs. 23 of 54, 42.6% with brimonidine; P = 0.025) and hands and feet that became cold easily (24 of 53, 45.3% vs. 12 of 54, 22.2% with brimonidine; P = 0.012).. As adjunct therapy with beta-blockers, brimonidine twice daily and latanoprost every day were comparable in lowering IOP at peak effect, but brimonidine was better tolerated, with fewer reports of adverse quality-of-life effects.

Topics: Adrenergic beta-Antagonists; Aged; Antihypertensive Agents; Brimonidine Tartrate; Chronic Disease; Cross-Over Studies; Double-Blind Method; Drug Therapy, Combination; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ocular Hypertension; Prospective Studies; Prostaglandins F, Synthetic; Quality of Life; Quinoxalines; Treatment Outcome

To compare the intraocular pressure (IOP)-reducing effect and side effects of 0.005% latanoprost once daily to 0.5% timolol twice daily in patients with primary chronic angle closure glaucoma (CACG).. Randomized, double-masked two-center clinical trial.. Thirty-two Asian patients with CACG, defined as glaucomatous optic neuropathy with a compatible visual field defect and at least 6 clock hours of synechial angle closure on gonioscopy were recruited. All patients had previous peripheral iridotomy (PI) with IOP >21 mmHg after PI and were thereafter controlled (IOP <22 mmHg) with one or two pressure-reducing drugs.. After a washout period, the patients were randomized to a 2-week treatment period with either placebo in the morning and 0.005% latanoprost in the evening or 0.5% timolol twice daily.. The short-term IOP reduction of latanoprost and timolol in patients with CACG. IOP was measured at baseline, and after 2, 7, and 14 days of treatment. In addition, the short-term ocular and systemic adverse events of the two drugs were evaluated.. Thirty patients completed the study. Two patients in the timolol group were withdrawn because of inadequate IOP control. Compared with baseline, the IOP after 2 weeks of treatment was statistically significantly reduced by 8.8 +/- 1.1 mmHg (mean +/- SEM, P < 0.001) in the latanoprost group, and by 5.7 +/- 0.9 mmHg (P < 0.001) in the timolol group. The difference in IOP reduction between the two treatment groups was 3.1 +/- 1.5 mm Hg in favor of latanoprost (P = 0.04). The main ocular adverse events reported in both treatment groups were conjunctival hyperemia and discomfort.. In this preliminary study, a significantly greater IOP reduction was achieved with 0.005% latanoprost once daily compared with 0.5% timolol twice daily in patients with CACG. The results suggest that latanoprost may be a therapeutic choice for the medical treatment of primary CACG.

Topics: Adrenergic beta-Antagonists; Aged; Antihypertensive Agents; Chronic Disease; Double-Blind Method; Drug Evaluation; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ophthalmic Solutions; Prostaglandins F, Synthetic; Timolol; Treatment Outcome

To determine the efficacy and safety of latanoprost treatment for 1 year in glaucoma patients, and to evaluate the effects of switching from timolol to latanoprost therapy.. Latanoprost 0.005% was topically applied once daily without masking for 6 months in 223 patients with elevated intraocular pressure after previous treatment with latanoprost once daily or 0.5% timolol twice daily for 6 months in a multicenter, randomized, double-masked, parallel group study.. Compared with baseline values before treatment, a significant (P < .0001) diurnal reduction in intraocular pressure of 6 to 8 mm Hg was maintained with minimal fluctuation for the duration of treatment. When treatment was switched from timolol to latanoprost, intraocular pressure was reduced by 1.5 +/- 0.3 mm Hg (mean +/- SEM; 8% change in intraocular pressure; 31% of the intraocular pressure reduction produced by timolol; P < .001) compared with the change in intraocular pressure in patients remaining on latanoprost therapy. Of the patients initially enrolled, 95% successfully completed treatment. There was a slight overall increase in conjunctival hyperemia in patients who switched from timolol to latanoprost, but no change in those who continued latanoprost. The timolol-induced reduction of resting heart rate returned to baseline levels after switching to latanoprost. Of the 247 patients treated with latanoprost during the masked and/or open-label studies, 12 (5%) demonstrated a definite (n = 4) or possible (n = 8) increase in iris pigmentation.. Latanoprost is a well-tolerated ocular hypotensive agent that appears to be more effective than timolol in reducing intraocular pressure. The increase in iris pigmentation appears to be harmless but requires further investigation.

Topics: Adult; Aged; Aged, 80 and over; Chronic Disease; Double-Blind Method; Drug Administration Schedule; Eye Color; Female; Glaucoma, Open-Angle; Heart Rate; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Prostaglandins F, Synthetic; Safety; Timolol

The scope of this work was to evaluate the effect on ocular pressure and on ocular blood flow of latanoprost 0.005% eyedrops. Included in the study were 12 patients (24 eyes) with POAG, aged between 37 and 48 years, non-smokers, refractions between +/- 3D. Haemorrheological parameters within normal, not in ocular or systemic vasoactive therapy. Each patient had one eye treated with latanoprost 0.005% and the other with timolol 0.05%. The choroidal perfusion was measured by Langham's POBF system during the first day of therapy and then after 7, 15, 30, 60, 90 and 180 days. The maximum pressure decrease after the first administration of latanoprost was at the twelfth hour; after 6 months of therapy, mean IOP reduction was 32.6%. POBF values increased up to 55.8% in the first day and then settled at 22.6% at the end of the study. Timolol showed a similar pressure progress, but its haematic perfusion values were distinctly lower. In conclusion, latanoprost is efficacious in POAG therapy since it unites a positive optic nerve head perfusion effect with hypotensive efficacy.

Topics: Adrenergic beta-Antagonists; Adult; Blood Flow Velocity; Choroid; Chronic Disease; Female; Follow-Up Studies; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ophthalmic Solutions; Prostaglandins F, Synthetic; Single-Blind Method; Timolol; Treatment Outcome

In this study, the authors report their experience with latanoprost after a year's treatment of patients with various forms of glaucoma at various stages of progression. The new drug was associated also with different beta-blockers. The case file reported includes 30 eyes of 18 patients treated with latanoprost once a day in the evening. Follow-up varied from 6 months to 1 year. Except for 2 patients (3 eyes) receiving only latanoprost therapy, all the others received latanoprost in association with their on-going therapy. Results are equivalent to those described in the literature. The authors also consider the results in two groups; chronic simple glaucoma and other forms of glaucoma. From their own experience and from what is reported in the literature, the authors conclude by stressing the pressure reducing efficacy of this drug.

Topics: Adrenergic beta-Antagonists; Adult; Aged; Chronic Disease; Drug Therapy, Combination; Female; Follow-Up Studies; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Parasympathomimetics; Prostaglandins F, Synthetic; Sympathetic Nervous System; Treatment Outcome; Visual Acuity

To determine whether once-daily, in the morning, topical application of the new ocular hypotensive prostaglandin analogue, latanoprost, yields nocturnal intraocular pressure (IOP) reduction similar to its diurnal IOP reducing efficacy.. Placebo- controlled, randomized, and double-masked study on hospitalized patients with ocular hypertension or glaucoma. Patients in group 1 (n=9) were maintained on twice-daily applications of 0.5% timolol maleate. Patients in group 2 (n=10) terminated their timolol treatment 3 weeks before the beginning of the study. In both groups the test drug (0.005% latanoprost) and its vehicle (placebo) was applied by hospital staff every morning for 9 days.. After 4 days of ambulatory treatment, patients were hospitalized, and IOP values were obtained in the supine and sitting positions with a handheld electronic tonometer (Tono-Pen XL, Bio-Rad, Glendale, Calif) and a Goldmann's applanation tonometer, covering every 2-hour interval, around the clock, but not more than at four time points per day during a 5-day period.. The mean nocturnal IOPs (Goldmann's applanation tonometer) collected for 5 days were mean +/-SEM 17.9+/-0.6 vs 20.2+/-0.6 mm Hg and 16.8+/-0.3 vs 20.6+/-0.5 mm Hg for the study vs the control eyes in group 1 and group 2, respectively. These nocturnal IOP reductions were statistically significant (P<.001, two-tailed paired Student's t test). The differences between diurnal and nocturnal IOP reductions (handheld electronic or Goldmann's applanation tonometer) were minimal (>0.3 mm Hg) and statistically not significant (P>.31, two-tailed paired Student's t test).. Once-daily latanoprost treatment provides uniform circadian (around-the-clock) IOP reduction by itself, or in combination with timolol.

Topics: Adrenergic beta-Antagonists; Adult; Aged; Aged, 80 and over; Chronic Disease; Circadian Rhythm; Double-Blind Method; Drug Administration Schedule; Drug Therapy, Combination; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Posture; Prostaglandins F, Synthetic; Timolol; Tonometry, Ocular

Churg-Strauss syndrome is a rare, systemic vasculitis of unknown cause. Ocular involvement is a rare but established complication and can lead to vision damage or blindness if not treated promptly. Treatment of ocular manifestations corresponds with systemic treatment of the disease and consists primarily of corticosteroids.

Topics: Administration, Ophthalmic; Antihypertensive Agents; Brimonidine Tartrate; Chronic Disease; Churg-Strauss Syndrome; Edema; Exophthalmos; Eye Diseases; Eyelids; Female; Glucocorticoids; Humans; Latanoprost; Methylprednisolone; Middle Aged; Ocular Hypertension; Prostaglandins F, Synthetic

Topics: Antidepressive Agents, Second-Generation; Antihypertensive Agents; Brimonidine Tartrate; Chronic Disease; Depressive Disorder; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Prostaglandins F, Synthetic; Tonometry, Ocular; Venlafaxine Hydrochloride

Hypotony with choroidal detachment is a rare complication of glaucoma medication. In this study, we report on a case which supports the hypothesis that has been proposed to explain this phenomenon.. This study was designed as an observational case report.. A woman with chronic glaucoma underwent trabeculectomy on both eyes. Low intraocular pressure (IOP) developed in 1 eye only, with no visual change for many years. After cataract surgery, the IOP increased, necessitating treatment with topical timolol 0.5% and dorzolamide 2%. She developed monocular hypotony and choroidal detachment 3 months later. This complication occurred in the eye that had previously had a low IOP and resolved completely when topical medication was stopped. The choroidal detachment recurred when rechallenged with the same medication.. Topical aqueous suppression therapy can result in hypotony and choroidal detachment in an eye in which relatively low IOP has been maintained for many years after glaucoma filtration surgery. The problem resolves on stopping the medication.

Topics: Adrenergic beta-Antagonists; Antihypertensive Agents; Carbonic Anhydrase Inhibitors; Cataract Extraction; Choroid Diseases; Chronic Disease; Drug Interactions; Drug Therapy, Combination; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Middle Aged; Ocular Hypotension; Ophthalmic Solutions; Prostaglandins F, Synthetic; Recurrence; Sulfonamides; Thiophenes; Timolol; Trabeculectomy

The aim of this study was to evaluate the efficacy of 0.005% latanoprost in lowering intraocular pressure (IOP) in patients with chronic angle-closure glaucoma (CACG) and no visible ciliary-body face. Fourteen eyes of 14 Korean patients with CACG with 360 degrees of peripheral anterior synechiae (PAS) and an IOP greater than 21 mmHg without medication were treated with 0.005% latanoprost once-daily. All patients completed 3 months of treatment with latanoprost. The IOP, which was 30.3 +/- 4.5 (mean +/- standard deviation) mmHg at baseline, decreased to 22.6 +/- 4.9 mmHg after 1 week, 19.6 +/- 5.5 mmHg after 1 month, 19.4 +/- 4.9 mmHg after 2 months, and 21.5 +/- 5.9 mmHg after 3 months of treatment with latanoprost (P < 0.01 for each). Ultrasound biomicroscopy of the anterior chamber angle showed anterior bowing of the iris with total occlusion of the angle by PAS, except for 5 eyes with focal microscopic openings to the ciliary-body face at various angles. Adverse ocular events were well-tolerated and transient. In this preliminary study, treatment with 0.005% latanoprost once-daily resulted in a significant reduction in IOP in CACG patients with 360 degrees of PAS on gonioscopy. Our results suggest that latanoprost may be considered as a therapy of choice in these rare cases.

Topics: Adult; Aged; Aged, 80 and over; Anterior Chamber; Antihypertensive Agents; Chronic Disease; Ciliary Body; Female; Glaucoma, Angle-Closure; Gonioscopy; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Prostaglandins F, Synthetic; Safety; Treatment Outcome; Ultrasonography

To determine utilisation patterns and calculate treatment failure and discontinuation rates in patients with open angle glaucoma treated in the United Kingdom with any of six groups of intraocular pressure (IOP) lowering agents.. The UK General Practice Research Database was used to identify newly diagnosed (after 1 January 1997) open angle glaucoma patients who were naive to therapy with any of six index drug groups: carbonic anhydrase inhibitors, latanoprost, miotics, sympathomimetics, timolol, and other (non-timolol) beta blockers. Analyses included drug treatment data for 1 year following diagnosis. Outcomes were (1) time to therapy failure, defined as either change in index drug (replacement or addition of therapy) or patient referral for surgery, and (2) time to therapy discontinuation, defined as either therapy failure or no refill of the index drug in a period twice that covered by the first prescription fill. Cox proportional hazard regression and Kaplan-Meier and life table methods were used to compare groups.. Among the 2001 eligible patients, a beta blocker other than timolol was the most widely prescribed (42%), followed by timolol (32%), carbonic anhydrase inhibitors (10%), and latanoprost (7%). Compared to latanoprost, those treated with any alternative agent were significantly more likely to fail (p < or = 0.005 for each comparison) and to discontinue (p < or = 0.05 for each comparison) therapy. Failure rates ranged from 13% (latanoprost) to 45% (sympathomimetics), and discontinuation rates ranged from 30% (latanoprost) to 63% (miotics).. Latanoprost treated patients demonstrated lower rates of therapy failure and therapy discontinuation compared with patients treated with other widely used IOP lowering medications, including beta blockers.

Topics: Adrenergic beta-Antagonists; Aged; Antihypertensive Agents; Carbonic Anhydrase Inhibitors; Chronic Disease; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Miotics; Prostaglandins F, Synthetic; Risk Factors; Sympathomimetics; Timolol; Treatment Failure

Latanoprost may be a useful adjunct in some patients receiving maximum tolerated medical therapy. We report our clinical experience with latanoprost when added to one or two other glaucoma medications.. Review of the charts of 53 patients with open-angle glaucoma whose intraocular pressure (IOP) was uncontrolled with one or two glaucoma medications and who had latanoprost added as a second or third drug. Patients whose IOP decreased by 3 mm Hg or more were considered to be responders.. The shortest length of follow-up was 2.3 months (median 5.8 months). Latanoprost was given as a second medication to 35 patients, of whom 22 (63%) responded, with a mean IOP reduction of 6.1 mm Hg (standard deviation [SD] 2.73 mm Hg) (28.7% [SD 12.10%]). Of the 18 patients to whom latanoprost was given as a third medication, 10 (56%) responded, with a mean IOP reduction of 6.3 mm Hg (SD 3.86 mm Hg) (24.5% [SD 10.12%]).. Latanoprost provides additional IOP reduction in some patients with open-angle glaucoma when added to one or two other glaucoma medications.

Topics: Adrenergic beta-Antagonists; Aged; Antihypertensive Agents; Chemotherapy, Adjuvant; Cholinergic Agents; Chronic Disease; Exfoliation Syndrome; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Prostaglandins F, Synthetic; Treatment Outcome

To investigate the incidence of visually significant cystoid macular edema associated with the use of latanoprost in patients with glaucoma after cataract surgery.. This is a multicenter, retrospective study of 185 patients, of whom 173 were pseudophakic (212 eyes) and 12 were aphakic (13 eyes), who were treated for glaucoma with latanoprost 0.005%. The posterior lens capsule was intact in 125 eyes, open or absent as a result of surgery in 25 eyes, and status-post-yttrium-aluminum-garnet capsulotomy in 75 eyes. Visual acuity was documented before and after initiating latanoprost therapy, and patients with a reduction of two or more lines on the Snellen chart were examined by fluorescein angiography for cystoid macular edema.. Visual reduction was documented in four (2.16%) patients. Three of the four patients had cystoid macular edema, and the fourth was thought to have lost a central island of vision from glaucoma. The three patients with cystoid macular edema all had ruptured posterior capsules, requiring anterior vitrectomy, and one had a previous episode of cystoid macular edema 3 years before starting latanoprost therapy.. These findings suggest that visually significant cystoid macular edema associated with latanoprost therapy in pseudophakic or aphakic patients is uncommon. If there is a cause-and-effect relationship between latanoprost therapy and clinically significant cystoid macular edema, the incidence appears to be low.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Aphakia, Postcataract; Cataract; Cataract Extraction; Child; Chronic Disease; Exfoliation Syndrome; Female; Fluorescein Angiography; Fundus Oculi; Glaucoma, Open-Angle; Humans; Incidence; Intraocular Pressure; Latanoprost; Macular Edema; Male; Middle Aged; Prostaglandins F, Synthetic; Pseudophakia; Retrospective Studies; United States; Visual Acuity

To describe presumed activation of herpetic keratouveitis after argon laser peripheral iridotomy.. Case report.. A 68-year-old man developed chronic, unilateral, anterior uveitis associated with decreased corneal sensation, focal keratitis, and increased intraocular pressure after argon laser peripheral iridotomy. Treatment with oral acyclovir and discontinuation of topical latanoprost resulted in prompt and continued control of both the intraocular inflammation and pressure.. Herpetic keratouveitis may occur after argon laser iridotomy, and it should be considered when postoperative inflammation persists despite appropriate use of topical corticosteroids, particularly in patients with a history of herpetic eye disease.

Topics: Acyclovir; Aged; Antiviral Agents; Chronic Disease; Glaucoma; Herpesvirus 1, Human; Humans; Intraocular Pressure; Iris; Keratitis, Herpetic; Laser Therapy; Latanoprost; Male; Prostaglandins F, Synthetic; Uveitis, Anterior; Virus Activation

Topics: Aged; Aged, 80 and over; Chronic Disease; Female; Fluorescein Angiography; Fundus Oculi; Glaucoma, Open-Angle; Humans; Latanoprost; Macular Edema; Prostaglandins F, Synthetic

The use of beta blockers for glaucoma treatment may cause serious bronchoconstriction in patients with chronic obstructive pulmonary disease. The synthetic prostaglandin (PG) F2 alpha-analogue latanoprost (13,14,dihydro-17-phenyl-18,19,20-trinor-PGF-2-alpha-iso propylester) represents a new class of drugs for glaucoma treatment. In this study the pulmonary tolerability to latanoprost in 12 healthy volunteers and 11 (one withdrawal due to a sty before latanoprost treatment) subjects with moderate but stable steroid-treated intrinsic asthma was examined. Asthmatic subjects received 30 microliters of vehicle (placebo) at the scheduled administration times on baseline day. On a second day, a minimum of one week later, increasing concentrations (0.35, 115 and 350 micrograms/ml) of latanoprost were added to the vehicle and given topically to both eyes. Healthy volunteers were given latanoprost only. ECG, blood pressure, heart rate, forced expiratory volume (FEV1), peak expiratory outflow (PEF) and forced vital capacity (FVC) were recorded immediately prior to and 15, 30, 45 and 60 minutes after latanoprost. Asthmatic patients inhaled salbutamol (0.2 mg) at 60 minutes after the highest latanoprost dose. There were no significant differences in pulmonary function, blood pressure or heart rate after latanoprost in the healthy volunteers. Moreover, all parameters were unaffected in asthmatic patients on the day latanoprost was given compared to the baseline day. Latanoprost did not dampen the bronchodilator response to beta-2-adrenergic stimulation. It is concluded that latanoprost did not affect lung function in healthy subjects or in asthmatics after a total accumulated dose 10 times that clinically recommended for glaucoma treatment. Therefore, latanoprost appears to be safe for glaucoma treatment in patients with steroid-treated stable moderate intrinsic asthma.

Topics: Administration, Inhalation; Administration, Topical; Adrenergic beta-Agonists; Adult; Aged; Albuterol; Asthma; Chronic Disease; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Glaucoma; Hemodynamics; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ophthalmic Solutions; Prostaglandins F, Synthetic; Respiration; Respiratory Function Tests; Treatment Outcome