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Effect of timolol, latanoprost, and dorzolamide on circadian IOP in glaucoma or ocular hypertension.

Abstract

PURPOSE

To compare the around-the-clock intraocular pressure (IOP) reduction induced by timolol 0.5%, latanoprost 0.005%, and dorzolamide in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT).

METHODS

In this crossover trial, 20 patients with POAG (n = 10) or OHT (n = 10) were treated with timolol, latanoprost, and dorzolamide for 1 month. The treatment sequence was randomized. All patients underwent measurements for four 24-hour tonometric curves: at baseline and after each 1-month period of treatment. The patients were admitted to the hospital, and IOP was measured by two well-trained evaluators masked to treatment assignment. Measurements were taken at 3, 6, and 9 AM and noon and at 3, 6, and 9 PM and midnight by handheld electronic tonometer (TonoPen XL; Bio-Rad, Glendale, CA) with the patient supine and sitting, and a Goldmann applanation tonometer (Haag-Streit, Bern, Switzerland) with the patient sitting at the slit lamp. Systemic blood pressure was recorded at the same times. The between-group differences were tested for significance by means of parametric analysis of variance. The circadian IOP curve of a small group of untreated healthy young subjects was also recorded using the same procedures. To compare the circadian IOP rhythms in the POAG-OHT and control groups, the acrophases for each subject were calculated.

RESULTS

When Goldmann sitting values were considered, all the drugs significantly reduced IOP in comparison with baseline at all times, except for timolol at 3 AM. Latanoprost was more effective in lowering IOP than timolol at 3, 6, and 9 AM (P = 0.03), noon (P = 0.01), 9 PM, and midnight (P = 0.05) and was more effective than dorzolamide at 9 AM, noon (P = 0.03), and 3 and 6 PM (P = 0.04). Timolol was more effective than dorzolamide at 3 PM (P = 0.05), whereas dorzolamide performed better than timolol at midnight and 3 AM (P = 0.05). An ancillary finding of this study was that in the group of healthy subjects, the pattern of IOP curve was different that in patients with eye disease.

CONCLUSIONS

Latanoprost seemed to lead to a fairly uniform circadian reduction in IOP, whereas timolol seemed to be less effective during the nighttime hours. Dorzolamide was less effective than latanoprost but led to a significant reduction in nocturnal IOP. The reason for the difference in the pattern of the IOP curve of healthy subjects is currently unknown and deserves further investigation.

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  • Authors+Show Affiliations

    ,

    Eye Clinic, Institute of Biomedical Sciences, San Paolo Hospital, University of Milan, Italy. orzalesi@mailserver.unimi.it

    , , ,

    Source

    MeSH

    Aged
    Antihypertensive Agents
    Circadian Rhythm
    Cross-Over Studies
    Female
    Glaucoma, Open-Angle
    Humans
    Intraocular Pressure
    Latanoprost
    Male
    Ocular Hypertension
    Ophthalmic Solutions
    Prostaglandins F, Synthetic
    Sulfonamides
    Thiophenes
    Timolol
    Tonometry, Ocular

    Pub Type(s)

    Clinical Trial
    Comparative Study
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    10937568

    Citation

    Orzalesi, N, et al. "Effect of Timolol, Latanoprost, and Dorzolamide On Circadian IOP in Glaucoma or Ocular Hypertension." Investigative Ophthalmology & Visual Science, vol. 41, no. 9, 2000, pp. 2566-73.
    Orzalesi N, Rossetti L, Invernizzi T, et al. Effect of timolol, latanoprost, and dorzolamide on circadian IOP in glaucoma or ocular hypertension. Invest Ophthalmol Vis Sci. 2000;41(9):2566-73.
    Orzalesi, N., Rossetti, L., Invernizzi, T., Bottoli, A., & Autelitano, A. (2000). Effect of timolol, latanoprost, and dorzolamide on circadian IOP in glaucoma or ocular hypertension. Investigative Ophthalmology & Visual Science, 41(9), pp. 2566-73.
    Orzalesi N, et al. Effect of Timolol, Latanoprost, and Dorzolamide On Circadian IOP in Glaucoma or Ocular Hypertension. Invest Ophthalmol Vis Sci. 2000;41(9):2566-73. PubMed PMID: 10937568.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effect of timolol, latanoprost, and dorzolamide on circadian IOP in glaucoma or ocular hypertension. AU - Orzalesi,N, AU - Rossetti,L, AU - Invernizzi,T, AU - Bottoli,A, AU - Autelitano,A, PY - 2000/8/11/pubmed PY - 2000/8/19/medline PY - 2000/8/11/entrez SP - 2566 EP - 73 JF - Investigative ophthalmology & visual science JO - Invest. Ophthalmol. Vis. Sci. VL - 41 IS - 9 N2 - PURPOSE: To compare the around-the-clock intraocular pressure (IOP) reduction induced by timolol 0.5%, latanoprost 0.005%, and dorzolamide in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT). METHODS: In this crossover trial, 20 patients with POAG (n = 10) or OHT (n = 10) were treated with timolol, latanoprost, and dorzolamide for 1 month. The treatment sequence was randomized. All patients underwent measurements for four 24-hour tonometric curves: at baseline and after each 1-month period of treatment. The patients were admitted to the hospital, and IOP was measured by two well-trained evaluators masked to treatment assignment. Measurements were taken at 3, 6, and 9 AM and noon and at 3, 6, and 9 PM and midnight by handheld electronic tonometer (TonoPen XL; Bio-Rad, Glendale, CA) with the patient supine and sitting, and a Goldmann applanation tonometer (Haag-Streit, Bern, Switzerland) with the patient sitting at the slit lamp. Systemic blood pressure was recorded at the same times. The between-group differences were tested for significance by means of parametric analysis of variance. The circadian IOP curve of a small group of untreated healthy young subjects was also recorded using the same procedures. To compare the circadian IOP rhythms in the POAG-OHT and control groups, the acrophases for each subject were calculated. RESULTS: When Goldmann sitting values were considered, all the drugs significantly reduced IOP in comparison with baseline at all times, except for timolol at 3 AM. Latanoprost was more effective in lowering IOP than timolol at 3, 6, and 9 AM (P = 0.03), noon (P = 0.01), 9 PM, and midnight (P = 0.05) and was more effective than dorzolamide at 9 AM, noon (P = 0.03), and 3 and 6 PM (P = 0.04). Timolol was more effective than dorzolamide at 3 PM (P = 0.05), whereas dorzolamide performed better than timolol at midnight and 3 AM (P = 0.05). An ancillary finding of this study was that in the group of healthy subjects, the pattern of IOP curve was different that in patients with eye disease. CONCLUSIONS: Latanoprost seemed to lead to a fairly uniform circadian reduction in IOP, whereas timolol seemed to be less effective during the nighttime hours. Dorzolamide was less effective than latanoprost but led to a significant reduction in nocturnal IOP. The reason for the difference in the pattern of the IOP curve of healthy subjects is currently unknown and deserves further investigation. SN - 0146-0404 UR - https://www.unboundmedicine.com/medline/citation/10937568/Effect_of_timolol_latanoprost_and_dorzolamide_on_circadian_IOP_in_glaucoma_or_ocular_hypertension_ L2 - http://iovs.arvojournals.org/article.aspx?volume=41&page=2566 DB - PRIME DP - Unbound Medicine ER -