Document Detail

Twenty-four hour intraocular pressure reduction with latanoprost compared with pilocarpine as third-line therapy in exfoliation glaucoma.
MedLine Citation:
PMID:  11318297     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To compare the 24 hour efficacy of latanoprost 0.005% given every evening with that of pilocarpine 4% given four times daily as third-line therapy in patients with exfoliation glaucoma receiving timolol 0.5% and dorzolamide 2% each given twice daily. METHOD: We enrolled 30 patients with exfoliation glaucoma not adequately controlled on timolol maleate 0.5% and dorzolamide 2%. Each patient underwent a baseline 24 hour intraocular pressure curve testing at 06:00, 10:00, 14:00, 18:00, 22:00 and 02:00 hours. Patients were randomised to receive either latanoprost 0.005% or pilocarpine 4% for a minimum of 8 weeks and were then crossed over to the opposite therapy. Diurnal curve testing was repeated at the end of each treatment. RESULTS: There was a significant decrease from baseline in intraocular pressure at each timepoint for both study medicines (p < 0.016). Latanoprost provided better intraocular pressure control than pilocarpine at daytime measuresments (17.4 vs 19.7 mmHg at 06:00 hours, p < 0.001; 17.8 vs 19.1 mmHg at 10:00 hours, p = 0.04). However, pilocarpine reduced the pressure more than latanoprost at 22:00 hours (18.4 vs 19.5 mmHg, p = 0.016). Overall, the diurnal intraocular pressure was reduced from a baseline of 21.5 +/- 3.7 mmHg to 18.8 +/- 3.1 mmHg on pilocarpine and to 18.0 +/- 3.0 mmHg on latanoprost (p = 0.06). In addition, mean peak pressure was similar between pilocarpine (21.0 +/- 2.9 mmHg) and latanoprost (20.5 +/- 3.8 mmHg) (p = 0.20). Side-effects were similar with the exception of blurred vision, which was only found with pilocarpine (10%). Compliance was more difficult with pilocarpine. CONCLUSION: In exfoliation glaucoma, as a third-line adjunctive therapy added to timolol and dorzolamide, latanoprost and pilocarpine have similar diurnal efficacy. However, latanoprost provides a greater morning pressure reduction.
A G Konstas; S Lake; A C Maltezos; K T Holmes; W C Stewart
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Eye (London, England)     Volume:  15     ISSN:  0950-222X     ISO Abbreviation:  Eye (Lond)     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-04-24     Completed Date:  2001-05-17     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  8703986     Medline TA:  Eye (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  59-62     Citation Subset:  IM    
University Department of Ophthalmology AHEPA Hospital, Thessaloniki, Greece.
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MeSH Terms
Antihypertensive Agents / therapeutic use*
Circadian Rhythm / physiology
Cross-Over Studies
Drug Administration Schedule
Glaucoma, Open-Angle / drug therapy*,  physiopathology
Intraocular Pressure / drug effects,  physiology
Middle Aged
Miotics / adverse effects,  therapeutic use
Muscarinic Agonists / adverse effects,  therapeutic use*
Pilocarpine / adverse effects,  therapeutic use*
Prospective Studies
Prostaglandins F, Synthetic / adverse effects,  therapeutic use*
Reg. No./Substance:
0/Antihypertensive Agents; 0/Miotics; 0/Muscarinic Agonists; 0/Prostaglandins F, Synthetic; 130209-82-4/latanoprost; 92-13-7/Pilocarpine

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