Objective:To characterize diurnal intraocular pressure (IOP)-changes in primary open-angle glaucoma by reproducing IOPs based on patient posture. Methods: In 148 patients with untreated primary open-angle glaucoma who...Objective:To characterize diurnal intraocular pressure (IOP)-changes in primary open-angle glaucoma by reproducing IOPs based on patient posture. Methods: In 148 patients with untreated primary open-angle glaucoma who had IOPs recorded during clinic hours that were less than 21 mm Hg (average,14.8± 3.2 mm Hg),we measured IOP by noncontact tonometry every 2 hours from 6 AM to midnight and every 3 hours from midnight to 6 AM with patients sitting and supine. The IOP was reproduced by designating the sitting IOP as measurements taken when the patient was awake and the supine IOP as measurements taken when the patient was asleep for each individual. The reproduced diurnal IOP was composed of 12 measurements that included 2 to 4 IOP levels measured with the patients supine and the rest while they were sitting. Results: The peak of sitting diurnal IOP (mean± SD) for 148 patients was 16.0± 2.7 mm Hg,which was significantly lower than the peak of supine IOP (18.9± 3.9 mm Hg) or the reproduced IOP (17.5± 3.6 mm Hg) (P < .001 for both comparisons). The average reproduced IOP at each measurement time peaked at 3 AM during sleep; with sitting diurnal IOP or supine diurnal IOP,the peak IOPs were at noon. Twenty-nine patients (20% ) with an IOP less than 21mmHg during clinic hours had a reproduced IOP of 21mmHg or greater while asleep,compared with only 5 patients (3% ) when the patients were sitting only. Conclusions: In patients with primary open-angle glaucoma and IOPs less than 21 mm Hg during clinic hours,20% of patients had a reproduced IOP of 21 mm Hg or greater,compared with only 3% who had an IOP of 21 mm Hg or greater while sitting. Intraocular pressures peaked in most patients during sleep.展开更多
Purpose: To compare 24-hour reduction in intraocular pressure (IOP) by latanoprost 0.005% ,travoprost 0.004% ,and bimatoprost 0.03% in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OH). Desi...Purpose: To compare 24-hour reduction in intraocular pressure (IOP) by latanoprost 0.005% ,travoprost 0.004% ,and bimatoprost 0.03% in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OH). Design: Randomized,double-masked,crossover study. Participants: Twenty-four patients with POAG and 20 with OH. Methods: Patients were treated with latanoprost,travoprost,and bimatoprost for 1 month. The treatment sequence was randomized,and washout lasted 30 days for each trial drug. Four 24-hour tonometric curves were recorded for each patient: 1 at baseline and 1 after each treatment period. Main Outcome Measures: Intraocular pressure was measured at 3,6,and 9 am; noon; 3,6,and 9 pm; and midnight by 2 treatment-masked well-trained evaluators using a handheld electronic tonometer with the patient in supine and sitting positions and a Goldmann applanation tonometer with the patient sitting at the slit lamp. Supine systemic blood pressure was recorded at the same times. A randomized-blocks analysis of variance was used to analyze data. Results: All 3 drugs were highly effective in reducing IOP when compared to baseline. Mean IOP reductions were similar after the 3 prostaglandin analogs,and none of the differences among treatments reached statistical significance. The drugs’ effect was significantly greater during the daytime (9 am-9 pm) than during the nighttime (midnight-6 am) with all prostaglandin analogs. In 7 of 44 patients (16% ),nocturnal IOP was significantly higher than diurnal IOP,both at baseline and under the 3 prostaglandin analogs. Conclusions: From a clinical point of view,the overall results seem to indicate that the 3 prostaglandin analogs are powerful agents in controlling round-the-clock IOP in POAG and OH patients.展开更多
Purpose: To evaluate the efficacy and safety of bimatoprost 0.03 percent given every evening versus timolol maleate 0.5 per-cent/dorzolamide 2 percent fixed combination (TDFC) given twice daily in open-angle glaucoma ...Purpose: To evaluate the efficacy and safety of bimatoprost 0.03 percent given every evening versus timolol maleate 0.5 per-cent/dorzolamide 2 percent fixed combination (TDFC) given twice daily in open-angle glaucoma and ocular hypertensive patients. Design: A single-masked, two center, crossover comparison with two eight-week treatment periods following a four-week medicine free run-in period. Diurnal curve intraoc-展开更多
文摘Objective:To characterize diurnal intraocular pressure (IOP)-changes in primary open-angle glaucoma by reproducing IOPs based on patient posture. Methods: In 148 patients with untreated primary open-angle glaucoma who had IOPs recorded during clinic hours that were less than 21 mm Hg (average,14.8± 3.2 mm Hg),we measured IOP by noncontact tonometry every 2 hours from 6 AM to midnight and every 3 hours from midnight to 6 AM with patients sitting and supine. The IOP was reproduced by designating the sitting IOP as measurements taken when the patient was awake and the supine IOP as measurements taken when the patient was asleep for each individual. The reproduced diurnal IOP was composed of 12 measurements that included 2 to 4 IOP levels measured with the patients supine and the rest while they were sitting. Results: The peak of sitting diurnal IOP (mean± SD) for 148 patients was 16.0± 2.7 mm Hg,which was significantly lower than the peak of supine IOP (18.9± 3.9 mm Hg) or the reproduced IOP (17.5± 3.6 mm Hg) (P < .001 for both comparisons). The average reproduced IOP at each measurement time peaked at 3 AM during sleep; with sitting diurnal IOP or supine diurnal IOP,the peak IOPs were at noon. Twenty-nine patients (20% ) with an IOP less than 21mmHg during clinic hours had a reproduced IOP of 21mmHg or greater while asleep,compared with only 5 patients (3% ) when the patients were sitting only. Conclusions: In patients with primary open-angle glaucoma and IOPs less than 21 mm Hg during clinic hours,20% of patients had a reproduced IOP of 21 mm Hg or greater,compared with only 3% who had an IOP of 21 mm Hg or greater while sitting. Intraocular pressures peaked in most patients during sleep.
文摘Purpose: To compare 24-hour reduction in intraocular pressure (IOP) by latanoprost 0.005% ,travoprost 0.004% ,and bimatoprost 0.03% in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OH). Design: Randomized,double-masked,crossover study. Participants: Twenty-four patients with POAG and 20 with OH. Methods: Patients were treated with latanoprost,travoprost,and bimatoprost for 1 month. The treatment sequence was randomized,and washout lasted 30 days for each trial drug. Four 24-hour tonometric curves were recorded for each patient: 1 at baseline and 1 after each treatment period. Main Outcome Measures: Intraocular pressure was measured at 3,6,and 9 am; noon; 3,6,and 9 pm; and midnight by 2 treatment-masked well-trained evaluators using a handheld electronic tonometer with the patient in supine and sitting positions and a Goldmann applanation tonometer with the patient sitting at the slit lamp. Supine systemic blood pressure was recorded at the same times. A randomized-blocks analysis of variance was used to analyze data. Results: All 3 drugs were highly effective in reducing IOP when compared to baseline. Mean IOP reductions were similar after the 3 prostaglandin analogs,and none of the differences among treatments reached statistical significance. The drugs’ effect was significantly greater during the daytime (9 am-9 pm) than during the nighttime (midnight-6 am) with all prostaglandin analogs. In 7 of 44 patients (16% ),nocturnal IOP was significantly higher than diurnal IOP,both at baseline and under the 3 prostaglandin analogs. Conclusions: From a clinical point of view,the overall results seem to indicate that the 3 prostaglandin analogs are powerful agents in controlling round-the-clock IOP in POAG and OH patients.
文摘Purpose: To evaluate the efficacy and safety of bimatoprost 0.03 percent given every evening versus timolol maleate 0.5 per-cent/dorzolamide 2 percent fixed combination (TDFC) given twice daily in open-angle glaucoma and ocular hypertensive patients. Design: A single-masked, two center, crossover comparison with two eight-week treatment periods following a four-week medicine free run-in period. Diurnal curve intraoc-
