latanoprost and Glaucoma--Angle-Closure

To systematically evaluate the safety and efficacy of latanoprost monotherapy for the treatment of patients with angle-closure glaucoma.. We searched EMBASE, Medline, Cochrane Library, Chinese Journal Full-text Database (CNKI), Chinese Science and Technology Periodical Database (VIP), and Wang Fang using the search terms "latanoprost" (or its commercial name, Xalatan) and "angle-closure glaucoma." Resulting articles were then screened using preset inclusion criteria. Subgroup and sensitivity analyses were performed to evaluate the impact of research population, research type (blinded or controlled), and withdrawal/loss to follow-up.. A total of 17 studies (n=807) were included in this meta-analysis. The primary outcome measure was intraocular pressure (IOP). Changes in the mean, peak, and trough IOP from baseline were used as effect measures. As I statistic revealed statistical heterogeneity, the random-effects model was applied. With the exception of 2 non-Asian populations from Australia and Peru, all 13 countries included in this study were from Asia. Latanoprost reduced mean IOP by 7.9 mm Hg (32.4%), peak IOP by 7.4 mm Hg (29.8%), and trough IOP by 7.9 mm Hg (32.5%). The most frequent ocular adverse effects were ocular hyperemia, discomfort (including eye irritation, ocular discomfort, foreign body sensation, and itching), and blurred vision with a total incidence rate of 9.4%, 8.7%, and 5.2%, respectively. Systemic adverse effects encompass rhinitis, dizziness, headache, and nonspecific skin pigmentation.. Latanoprost is effective at reducing the IOP of patients with angle-closure glaucoma. Adverse reactions associated with latanoprost were mainly ocular in nature.

Topics: Administration, Topical; Aged, 80 and over; Antihypertensive Agents; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Latanoprost; Ophthalmic Solutions; Prostaglandins F, Synthetic; Tonometry, Ocular

To evaluate the efficacy and tolerability of latanoprost compared with timolol in the treatment of patients with chronic angle-closure glaucoma (CACG).. Pertinent publications were identified through systematic searches of PubMed, EMBASE, the Cochrane Controlled Trials Register and the Chinese Biomedicine Database. Randomized controlled trials comparing latanoprost with timolol in patients with chronic angle-closure glaucoma (CACG) who had inadequate intraocular pressure (IOP) control after peripheral iridotomy (PI) were selected. The main efficacy measures were the weighted mean difference (WMD) in the reduction from baseline to end of treatment in IOP at peak, trough, and diurnal curve. The main tolerability measures were the odds ratio (OR) for the individual adverse events. The pooled estimates and 95% confidence intervals (CIs) were carried out in RevMan version 5.2 software.. Five published randomized controlled trials involving 528 patients were included in the present meta-analysis. The IOP reduction (IOPR) was significantly greater in the latanoprost group than in the timolol group at diurnal curve (WMD: 2.22 mmHg [95% CI, 1.65 to 2.79], P < 0.00001), peak (WMD: 2.44 mmHg [0.85 to 4.03], P = 0.003) and trough (WMD: 2.67 mmHg [1.93 to 3.41], P < 0.00001). Timolol caused conjunctival hyperemia in less patients than latanoprost (pooled OR: 2.74 [95% CI, 1.33 to 5.61], P = 0.006).. Latanoprost provides greater IOP-lowering efficacy than timolol in the treatment of patients with CACG. Latanoprost caused conjunctival hyperemia in more patients than timolol. Further clinical trials are needed because of short duration of included studies.

Topics: Antihypertensive Agents; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Latanoprost; Prostaglandins F, Synthetic; Randomized Controlled Trials as Topic; Timolol; Treatment Outcome

To evaluate the efficacy and safety of latanoprost compared with timolol in the treatment of Asian patients with chronic angle-closure glaucoma (CACG).. Relevant trials were identified through systematic searches of Medline, EMBASE, PubMed, Cochrane Library, Google Scholar and several Chinese databases. The main outcome measures included absolute and relative reduction of intraocular pressure (IOP) at mean, peak and trough from baseline, ocular adverse effects and systemic adverse events.. Seven randomized controlled trials with 685 patients were included. In comparison with timolol, latanoprost reduced absolute IOP in CACG patients by more than 2.3 mmHg (95%CI, 1.8∼2.9, P<0.01), 2.4 mmHg (95%CI, 1.9∼2.9, P<0.01) and 2.5 mmHg (95%CI, 1.6∼3.3, P<0.01) at mean, peak and trough, respectively. As for relative IOP, there is 9.0% (95%CI, 6.6∼11.4, P<0.01), 9.7% (95%CI, 7.6∼11.8, P<0.01), and 10.8% (95%CI, 7.4∼14.3, P<0.01) greater reduction among latanoprost users than among timolol users. The differences were statistically significant at all time points (1, 2, 4, 8, 12, and 24 weeks). More ocular adverse effects (OR = 1.49, 95% CI, 1.05∼2.10, P = 0.02) and less systemic adverse events (OR = 0.46, 95% CI, 0.25∼0.84, P = 0.01) were observed in latanoprost group in comparison with timolol group.. Compared with timolol, latanoprost was significantly more effective in lowering IOP of Asian patients with CACG, with higher risk of ocular adverse effects but lower risk of systemic adverse events, and might be a good substitute for CACG patients.

Topics: Asia; Glaucoma, Angle-Closure; Humans; Latanoprost; Prostaglandins F, Synthetic; Randomized Controlled Trials as Topic; Safety; Timolol

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

Almost five years have elapsed since the introduction of latanoprost on several markets and considering the large number of publications dealing with it, the authors felt that it was worth re-evaluating the drug.. The criterion used to select trials for inclusion in the review was: all articles mentioning the drug in common electronic data-bases; these were then screened and considered, on the basis of methodological quality.. Experimental data suggest that latanoprost acts by remodeling the extracellular matrix in the ciliary muscle, thus increasing the flow of aqueous humor through the ciliary muscle bundles of the uveoscleral pathway. POAG: Latanoprost persistently improves the pulsatile ocular blood flow in primary open angle glaucoma (POAG). Recent trials confirmed the greater IOP-lowering efficacy of latanoprost vs. timolol, dorzolamide, brimonidine and unoprostone. Trials lasting up to 24 months showed that latanoprost is effective in long-term treatment of POAG and ocular hypertension (OH), with no signs of loss of efficacy when compared to timolol or dorzolamide. Latanoprost provides better control of circadian IOP. Non-responders to beta-blockers should preferably be switched to latanoprost monotherapy before a combination therapy is started. The possibility of a fixed combination of latanoprost and timolol has been explored, with promising results. NTG: Latanoprost is effective in normal tension glaucoma (NTG), lowering IOP, improving pulsatile ocular blood flow and increasing ocular perfusion pressure. OTHER GLAUCOMAS: Latanoprost may provide effective IOP control in angle-closure glaucoma after iridectomy, in pigmentary glaucoma, glaucoma after cataract extraction and steroid-induced glaucoma. However, latanoprost was effective in only a minority of pediatric cases of glaucoma and is contraindicated in all forms of uveitic glaucoma.. In the articles reviewed, new or duration-related adverse events were reported.

Topics: Antihypertensive Agents; Aqueous Humor; Blood Flow Velocity; Circadian Rhythm; Clinical Trials as Topic; Drug Therapy, Combination; Eye; Glaucoma, Angle-Closure; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Ocular Hypertension; Prostaglandins F, Synthetic; Safety; Sulfonamides; Thiophenes; Timolol

To assess the interventions to treat acute angle closure (AAC) and primary angle closure (PAC) with or without glaucomatous optic neuropathy.. Primary angle closure is one of the leading causes of blindness in East Asia. At present, there are few clinical guidelines on the optimal treatment of AAC or PAC in the affected or contralateral eye.. All randomized clinical trials, prospective controlled clinical trials, nonprospective controlled clinical trials, and retrospective case series with >50 cases that evaluated treatments for AAC or PAC were included. Studies published in the English language were identified from MEDLINE, PubMed, EMBASE, and the Cochrane Collaborations, as well as by a hand search of the reference lists of important articles.. Nine randomized clinical trials and 24 nonrandomized clinical trials and large case series were evaluated. Laser peripheral iridotomy (LPI) has been found to be as effective as surgical peripheral iridectomy in randomized clinical trials of the affected and contralateral eyes of AAC or PAC patients with or without evidence of glaucoma. In another randomized clinical trial, latanoprost was found to decrease intraocular pressure (IOP) more than timolol for PAC in patients for whom LPI alone failed.. This review suggests that LPI should be recommended for the treatment of affected and contralateral eyes of AAC patients. In patients with PAC and insufficient treatment with LPI, latanoprost eye drops may decrease IOP more than timolol. There is still insufficient evidence about other interventions for the treatment of AAC and PAC.

Topics: Acute Disease; Antihypertensive Agents; Evidence-Based Medicine; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Iridectomy; Latanoprost; Prospective Studies; Prostaglandins F, Synthetic; Randomized Controlled Trials as Topic

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

To compare the intraocular pressure (IOP) lowering efficacy and side effects of latanoprost 0.005% and bimatoprost 0.03% in subjects with chronic primary angle closure glaucoma (PACG).. This was an observer-masked randomised crossover study of 60 PACG subjects who received either latanoprost or bimatoprost for 6 weeks, after which they were crossed over to the other medication for another 6 weeks. The IOP-reducing effect of the medications was assessed by the reduction in IOP after 6 weeks of treatment compared with baseline.. Fifty-four subjects (80 eyes) completed the study. Latanoprost reduced IOP (mean (SD)) by 8.4 (3.8) mm Hg and bimatoprost by 8.9 (3.9) mm Hg from a baseline of 25.2 (3.6) mm Hg and 25.2 (3.6) mm Hg respectively (p = 0.23). Adverse events were mild in both groups; however there were twice as many reports of an adverse event in the bimatoprost group (81%) compared with the latanoprost group (40%, p<0.01). Ocular irritation was the most frequently reported adverse event in both groups; 22 subjects (37.9%) treated with bimatoprost experienced ocular hyperaemia as compared with 13 subjects (22.4%) treated with latanoprost (p = 0.11).. Bimatoprost once daily was similarly effective in reducing IOP compared with latanoprost once daily in subjects with chronic PACG. Both drugs were well tolerated with mild ocular adverse events.

Topics: Aged; Aged, 80 and over; Amides; Antihypertensive Agents; Bimatoprost; Cloprostenol; Cross-Over Studies; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Prostaglandins F, Synthetic; Single-Blind Method; Treatment Outcome

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

To evaluate the efficacy of topical antiglaucoma therapy in reducing acute intraocular pressure (IOP) elevation after neodymium: Yag laser iridotomy.. Primary angle-closure glaucoma (PACG) eyes were randomized to receive premedication with latanoprost and pilocarpine, brimonidine 0.2% and pilocarpine or only with pilocarpine before Yag laser iridotomy. Postoperative IOP changes were compared with Wilcoxon signed-ranks test using the fellow eyes in each group.. Postoperative pressure spikes were significantly lower in the groups of patients with local antiglaucoma therapy with pilocarpine than in the control group. Mean elevation of IOP was less in the groups of patients with local antiglaucoma therapy with pilocarpine at 2 hours postoperatively.. Local antiglaucoma therapy may reduce the acute IOP rise following Yag laser iridotomy in PACG eyes.

Topics: Aged; Aged, 80 and over; Antihypertensive Agents; Brimonidine Tartrate; Drug Therapy, Combination; Female; Glaucoma, Angle-Closure; Humans; Iris; Laser Therapy; Latanoprost; Male; Middle Aged; Miotics; Ocular Hypertension; Pilocarpine; Postoperative Complications; Prostaglandins F, Synthetic; Quinoxalines

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

Two independent, prospective trials were recently conducted to assess the efficacy of latanoprost in reducing intraocular pressure (IOP) in patients with primary angle-closure glaucoma (PACG). The first study was a 2-week, randomized, double-masked comparison of latanoprost treatment and timolol treatment in patients with PACG. Patients were randomized to one of two parallel treatment groups, receiving either placebo in the morning and latanoprost 0.005% in the evening, or timolol 0.5% twice daily. The mean IOP reduction in latanoprost group was 8.8 +/- 1.1 mm Hg (mean +/- SEM, p < 0.001; 34.2%) from a mean baseline IOP of 25.7 +/- 0.9 mm Hg, and the corresponding figures for the timolol group were 5.7 +/- 0.9 mm Hg (p < 0.001; 22.6%) from a mean baseline IOP of 25.2 +/- 1.1 mm Hg. A significantly greater IOP reduction of 3.1 +/- 1.5 mm Hg (95% confidence interval: 0.1 to 6.0) was achieved in the latanoprost group compared to the timolol treatment group (p = 0.04). In the second study, latanoprost 0.005% once a day was added adjunctively to PACG patients with persistently elevated IOP after iridectomy, despite treatment with beta-blockers and pilocarpine. The IOP decreased by about 21% during the first 3 months, and showed a reduction of about 36% at the end of 1 year. At the 1-year follow-up, IOP was <20 mm Hg in all eyes. In both studies, latanoprost was well tolerated with few adverse events. These results demonstrate that latanoprost is effective in reducing IOP in patients with PACG.

Topics: Adrenergic beta-Antagonists; Antihypertensive Agents; Double-Blind Method; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Latanoprost; Ophthalmic Solutions; Prospective Studies; Prostaglandins F, Synthetic; Safety; Timolol

To evaluate the efficacy of latanoprost in reducing acute intraocular pressure (IOP) elevation after neodymium:Yag laser iridotomy (LI).. Primary angle-closure glaucoma (PACG) eyes were randomized to receive premedication with latanoprost and pilocarpine or with pilocarpine only before LI. Postoperative IOP changes were compared with Wilcoxon signed-ranks test using the fellow eyes of 47 patients who had one eye in each group.. Postoperative pressure spikes were significantly lower (p = 0.010) in the latanoprost group (4.1 +/- 5.0 mmHg) than in the control group (6.7 +/- 7.0 mmHg). Mean elevation of IOP was less in the latanoprost group than in the control group at 1 hour (2.5 +/- 4.8 versus 4.1 +/- 4.7 mmHg, p = 0.013) and 2 hours (0.8 +/- 5.6 versus 4.4 +/- 8.1 mmHg, p = 0.003) postoperatively. Eleven eyes in the latanoprost group (23.4%) and 20 eyes in the control group (42.6%) developed a rise in IOP > or = 6 mmHg (p = 0.048).. Latanoprost may reduce the pressure rise following LI in PACG eyes, but its application is limited by a late onset of effect.

Topics: Acute Disease; Aged; Aged, 80 and over; Antihypertensive Agents; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Iris; Laser Therapy; Latanoprost; Male; Middle Aged; Ocular Hypertension; Pilocarpine; Premedication; Prostaglandins F, Synthetic; Safety; Tonometry, Ocular; Treatment Outcome; Visual Acuity

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

Latanoprost, and other prostaglandin analogs, have been previously associated with increased pigmentary reactions on the periocular skin. Here, we present a patient with paradoxical depigmentation of periocular skin within 1 year of latanoprost use in both eyes. This report is the first to document such an association, and clinicians should be aware of this adverse effect and monitor for signs accordingly.

Topics: Antihypertensive Agents; Eye Injuries; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Keratoplasty, Penetrating; Latanoprost; Male; Middle Aged; Pigmentation Disorders; Prostaglandins F, Synthetic; Rupture; Skin Pigmentation

To evaluate long-term efficacy of antiglaucoma medications with or without combined topical anti-inflammatory treatment in preventing increased intraocular pressure and clinical signs of glaucoma in eyes considered at risk of the development of the disease.. Retrospective analysis identified 88 canine patients presenting with unilateral acute congestive primary angle-closure glaucoma (IOP > 25 mm Hg) and gonioscopic findings of pectinate ligament dysplasia and/or narrow or closed iridocorneal angle in the contralateral nonglaucomatous eye. Patients with histopathologic confirmation of pectinate ligament dysplasia or angle closure in the initial glaucomatous eye receiving prophylactic medical therapy in the contralateral eye were included. Time to medical failure for each antiglaucoma medication and efficacy of the combination therapy were evaluated.. The most commonly affected pure-breds were the American Cocker Spaniel (20.4%) and Basset Hound (11.36%). The patients receiving demecarium bromide 0.125% had the longest estimated median time to medical failure at 330.0 days, followed by latanoprost 0.005%, dorzolamide hydrochloride 2.0%, and demecarium bromide 0.25% at 284.0 days, 272.5 days, and 143.0 days, respectively. The estimated median time to medical failure for patients receiving topical antiglaucoma and anti-inflammatory medication was 324.0 days versus 195.0 days in patients receiving antiglaucoma medication alone. Survival analysis showed no statistical significance.. None of the four antiglaucoma medications evaluated statistically delayed medical failure when compared to each other. Although significance was not achieved, our data suggest that adjunctive use of topical anti-inflammatory medications may be beneficial in these cases.

Topics: Administration, Topical; Animals; Anti-Inflammatory Agents; Antihypertensive Agents; Carbonic Anhydrase Inhibitors; Cholinesterase Inhibitors; Dog Diseases; Dogs; Female; Glaucoma, Angle-Closure; Intraocular Pressure; Latanoprost; Male; Prostaglandins F, Synthetic; Quaternary Ammonium Compounds; Retrospective Studies; Sulfonamides; Thiophenes

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

Acute angle closure glaucoma is an ocular emergency that is treatable with prompt and appropriate intervention. Recognition of this disease entity is sometimes difficult. We report a case of bilateral acute angle closure glaucoma in a 55-year-old, otherwise healthy individual, and discuss the different ways the condition may present. The anatomic and pathophysiologic progression leading to an event of angle closure is discussed and treatment modalities available to the Emergency Physician are presented.

Topics: Acetazolamide; Acute Disease; Analgesics; Antihypertensive Agents; Diuretics; Drug Therapy, Combination; Follow-Up Studies; Glaucoma, Angle-Closure; Headache; Humans; Latanoprost; Male; Middle Aged; Miotics; Pilocarpine; Prostaglandins F, Synthetic; Timolol; Treatment Outcome

Topics: Antihypertensive Agents; Female; Glaucoma, Angle-Closure; Humans; Hyperhidrosis; Intraocular Pressure; Latanoprost; Middle Aged; Ophthalmic Solutions; Prostaglandins F, Synthetic

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

Topics: Aged; Antihypertensive Agents; Cysts; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Iris Diseases; Latanoprost; Photography; Pigment Epithelium of Eye; Prostaglandins F, Synthetic

Topics: Acetazolamide; Acute Disease; Adult; Anticonvulsants; Epilepsies, Partial; Female; Fructose; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Latanoprost; Myopia; Prostaglandins F, Synthetic; Topiramate; Treatment Outcome

To observe and compare the effect of 0.005% latanoprost and 0.5% timolol solutions in the treatment of post-iridectomy residual angle-closure glaucoma.. Laser peripheral iridectomy was performed and 68 cases (68 eyes) of post-iridectomy residual angle-closure glaucoma were selected and treated with 0.005% latanoprost once at night as the study group and 0.5% timolol twice a day as the control group Intraocular pressure (IOP) was measured before treatment, on day 3, week 1, week 2, week 4, month 2, month 3 and month 6 in the follow-up, and visual acuity, visual field and C/D ratio were monitored.. Of 68 patients, 56 (82.4%) complete the 6 month follow-up. The basic IOP for all subjects in two groups before treatment was not statistically different (t = 0.236, P = 0.814). After the treatment for three days, the efficiency in IOP reduction was statistically different between 2 groups with repeated measure ANOVA (F = 287.441, P < 0.001). In each group, the IOP after treatment was statistically different from that at baseline, with t = 14.103, P < 0.001 and t = 10.308, P < 0.001 in the latanoprost and timolol groups respectively. For those patients who finished 6 months' follow-up, the IOP difference between the 2 groups was statistically significant with repeated measure ANOVA (F = 74.259, P < 0.001). The IOP was statistically reduced in both the latanoprost and the timolol groups with F = 148.787, P < 0.001 and F = 54.875, P < 0.001 respectively. At each follow-up time, the IOP in latanoprost group was statistically different from that of the timolol group with t values to be -6.127, -5.930, -6.201, -5.931, -7.412, -6.640 and -6.756 (P < 0.001). The IOP was statistically different from that before treatment in each group with a mean difference to be -7.034 approximately -6.897 in the latanoprost group and -4.704 approximately -5.000 in the timolol group (P < 0.001). The IOP was not statistically different within each group in the follow-up with mean difference of 0.034 approximately 0.138 (P = 0.904 approximately 0.629) in the latanoprost group and a mean difference of 0.037 approximately 0.296 (P = 0.910 approximately 0.366) in the timolol group. The best-corrected visual acuity, visual field and C/D ratio were not significantly changed during follow-up.. 0.005% latanoprost and 0.5% timolol can be used in the drug therapy of post-iridectomy angle-closure glaucoma and the efficiency of 0.005% latanoprost is better than of 0.5% timolol. Drug therapy of post-iridectomy angle-closure glaucoma is a practical strategy.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Drug Administration Schedule; Female; Follow-Up Studies; Glaucoma, Angle-Closure; Humans; Iridectomy; Laser Therapy; Latanoprost; Male; Middle Aged; Ophthalmic Solutions; Prospective Studies; Prostaglandins F, Synthetic; Timolol

Topics: Aged; Amides; Antihypertensive Agents; Bimatoprost; Cloprostenol; Drug Interactions; Drug Therapy, Combination; Female; Glaucoma, Angle-Closure; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Lipids; Male; Middle Aged; Ocular Hypertension; Prostaglandins F, Synthetic

Choroidal effusion and anterior chamber loss can occur in a trabeculectomized eye either spontaneously or following aqueous suppressant drug use.. A 50 year-old women with complaints of pain in the left eye (LE) was diagnosed as angle closure glaucoma. She was treated medically and underwent bilateral laser iridotomy. Because of high intraocular pressure it was decided to perform trabeculectomy. During the follow up period, the bleb became flat and after 3 months the IOP was again 24 mmHg with timolol maleate 0.5% and dorzolamide twice a day. Latanoprost was added to the therapy of the LE.. 12 days later the patient returned with pain and vision loss in her LE. The anterior chamber was diffusely narrow and ophthalmoscopy showed massive choroidal effusion.. The possible mechanisms of this complication were discussed.

Topics: Anterior Chamber; Antihypertensive Agents; Choroid Diseases; Exudates and Transudates; Female; Glaucoma, Angle-Closure; Glucocorticoids; Humans; Intraocular Pressure; Iridectomy; Laser Therapy; Latanoprost; Middle Aged; Mydriatics; Prostaglandins F, Synthetic; Trabeculectomy; Treatment Outcome; Visual Acuity

Residual primary angle-closure glaucoma (PACG) after iridectomy is an important issue among Asians, especially Chinese. In this study, we tested the effectiveness of latanoprost as an intraocular pressure (IOP) lowering agent in cases of residual PACG. Twenty-six eyes of 26 PACG patients with persistently elevated IOP after iridectomy, despite treatment with conventional IOP lowering drugs (beta blockers and pilocarpine) were included. Latanoprost 0.005%, one drop daily, was added adjunctively to all eyes. Measurement of IOP at baseline and after the start of treatment with latanoprost indicated a significant IOP reduction. The IOP decreased by about 21% (p < 0.005) during the first 3 months, and showed a reduction of about 36% at the end of 1 year. At the 1-year follow up, the IOP was well controlled (below 20 mmHg) in all eyes. These findings show that, in combination with beta blockade and pilocarpine, latanoprost can ameliorate residual PACG after iridectomy and could potentially forestall the need for further therapeutic intervention.

Topics: Adjuvants, Pharmaceutic; Aged; Antihypertensive Agents; Female; Glaucoma, Angle-Closure; Humans; Iris; Latanoprost; Male; Middle Aged; Prostaglandins F, Synthetic; Time Factors