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Abstract #8495 Published in IGR 5-1
Effect of bimatoprost on patients with primary open-angle glaucoma or ocular hypertension who are nonresponders to latanoprost
Gandolfi SA; Cimino LOphthalmology 2003; 110: 609-614
PURPOSE: To test the efficacy of bimatoprost 0.03% 2D for lowering intraocular pressure (IOP) in patients affected by primary open-angle glaucoma or ocular hypertension who did not respond to treatment with latanoprost 0.005% 2D. DESIGN: Prospective, randomized clinical trial with a crossover design (two 30-day treatment phases with a 30-day washout phase in between). PARTICIPANTS: Fifteen patients were enrolled. Random allocation to treatment to a single eye only of each subject. Eligibility criteria: (1) IOP > 22 mmHg in both eyes on current treatment (on three separate readings > 24 hours apart), (2) angle wide open in both eyes, (3) no pseudoexfoliation and/or pigment dispersion in either eye, (4) documented medical history consistent with < 10% IOP decrease in both eyes on two-month treatment with latanoprost 0.005% every day. METHOD: The following variables were measured at each study visit: (1) IOP (Goldmann applanation tonometry, five readings, 8 a.m., 12 noon, 4 p.m., 8 p.m., and midnight); (2) visual acuity (Early Treatment of Diabetic Retinopathy Study chart, logarithm of the minimum angle of resolution); (3) estimate of conjunctival hyperemia based on five standard photographs (graded as 'none', 'trace', 'mild', 'moderate', and 'severe'). MAIN OUTCOME MEASURE: IOP. RESULTS: IOP data (mean and standard deviation) were the following: baseline = 24.7 ± 0.9 mmHg, after washout = 24.8 ± 1.1 mmHg, after latanoprost phase = 24.1 ± 0.9 mmHg, after bimatoprost phase = 18.1 ± 1.7 mmHg. IOP on bimatoprost proved lower than both baseline (p < 0.0001) and latanoprost (p = 0.0001). Thirteen of 15 patients showed a > or =20% IOP decrease with bimatoprost treatment. None of the 15 patients showed a ≥ 20% decrease of IOP after 30 days of latanoprost treatment. No significant IOP changes were observed in the fellow untreated eye in each patient throughout the study. Trace-to-mild conjunctival hyperemia was recorded more often with bimatoprost phase (p = 0.035). CONCLUSIONS: Thirteen of 15 patients, who were nonresponders to latanoprost, 0.005%, 2D, were successfully treated with bimatoprost, 0.03%, 2D. Bimatoprost treatment was associated with a higher incidence of trace-to-mild conjunctival hyperemia than latanoprost.
Dr. S.A. Gandolfi, Glaucoma Service, Institute of Ophthalmology, University of Parma, Via Gramsci 14, 43100 Parma, Italy
Classification:
11.4 Prostaglandins (Part of: 11 Medical treatment)
