Effectiveness of 0.1% topical salicylic acid on blepharoconjunctivitis affecting glaucoma patients treated with topical prostaglandin analogues:a prospective randomized trial

AIM: To evaluate the efficacy of 0.1% topical salicylic acid（TSA） to treat iatrogenic chronic blepharoconjunctivitis in patients with primary open angle glaucoma（POAG）, treated with topical prostaglandin analogues（TPAs）.METHODS: Totally 60 patients were randomly distributed into 3 equal size groups, two of which treated with 0.1% TSA（OMKASA;） and 0.1% topical clobetasone butyrate（TCB; VISUCLOBEN;） respectively, and one consisting of untreated controls. The parameters taken into account at baseline（T0） and after 30 d（T1） of therapy were: conjunctival hyperemia, lacrimal function tests [Schirmer I test and break up time（BUT）] and intraocular pressure（IOP）.RESULTS: Conjunctival hyperemia showed a substantial improvement in both treated groups（P<0.001） but not among controls. Similarly, lacrimal function tests displayed an improvement of Schirmer I test in both treated groups（P<0.05） and an extension of BUT only in the group treated with 0.1% TSA（P<0.05）. The IOP increase was statistically significant only in those patients treated with 0.1% TCB（P<0.001）.CONCLUSION: The 0.1% TSA has proved to be an effective anti-inflammatory treatment of blepharoconjunctivitis affecting glaucoma patients on therapy with TPAs, leading to a sizeable decrease of inflammation as well as both quantitative and qualitative improvement of tear film. Furthermore, differently from 0.1% TCB, it does not induce any significant IOP increase.

Acute Uveitis in Neovascular Glaucoma Patient after a Single Dose of Travoprost

A 38-year-old man with no history of uveitis developed neovascular glaucoma (NVG) due to proliferative diabetic retinopathy (PDR). He had a history of ocular surgery with placement of glaucoma drainage implants (GDI), ultrasonic phacoemulsification, and intraocular lens implantation in both eyes. The patient had undergone a recent pars plana vitrectomy with complete panretinal photocoagulation (PRP) to clear vitreous hemorrhage in his right eye. To prevent progressive optic nerve damage, travoprost was tentatively administered because of inadequate intraocular pressure (IOP) control following surgery, laser treatment, and topical administration of many other IOP-lowering drugs. The patient experienced severe vision loss associated with acute anterior and intermediate uveitis. We consider it a rare complication due to the NVG patient’s vulnerability following ocular surgery. Given that acute uveitis developed rapidly and required time to resolve, systemic corticosteroid treatment could be considered to accelerate the resolution of inflammation.

Impact of Combination Use of 0.004% Travoprost and 2% Pilocarpine on Matrix Metalloproteinases Synthesized by Rabbit Ciliary Muscle:a Pilot Study

Objective To explore the impact of combination use of prostaglandin analogue and cholinergic agonists on main matrix metalloproteinases(MMPs)synthesized by albino rabbit ciliary muscle.Methods Normal adult albino rabbits were divided into the control group,2%pilocarpine group,0.004%travoprost group and travoprost plus pilocarpine group.Two rabbits in the control group were executed after treated with normal saline for one day.Two rabbits were separately executed on the 7th,14th and 24th day of the treatment in each drug treated group.In each subgroup ciliary muscle band of 4 eyes was taken and made into homogenate.The MMPs activities of 10 subgroups were assayed by zymography.Bands’intensity which represents the activity of MMPs was measured by the UltraViolet Illumination system.Results A bright band of MMP-1/2 was showed on each lane at the position corresponding to the molecular weight of 62 kD in the ciliary smooth muscles electrophoresis.When ion Zn and Ca was displaced by MMPs inhibitor EDTA,this bright band disappeared.Compared with the control group,MMP1/2 activity increased by 4.0%,4.1%and 14.0%after 7,14 and 24 days of pilocarpine treatment.Corresponding data was23.2%,61.7%and 111.5%in the travoprost group and 49.3%,68.0%and 88.4%in the travoprost plus pilocarpine group.Conclusions Pilocarpine has little effect on activity of MMP1/2.Travoprost can increase activity of MMP1/2 gradually.Activity of MMP1/2 is rapidly increased by pilocarpine combined with travoprost,but shows small change with the prolonged treatment.

Nitric oxide donating anti-glaucoma drugs:advances and prospects

Glaucoma is a disease that causes irreversible blindness. Reducing intraocular pressure(IOP) is the main treatment at present. Nitric oxide(NO), an endogenous gas signaling molecule, can increase aqueous humor outflow facility, inhibit aqueous humor production thereby reducing IOP, as well as regulate eye blood flow and protect the optic nerve. Therefore, NO donating antiglaucoma drugs have broad research prospects. In this review, we summarize NO-mediated therapy for glaucoma, and the state of the art of some NO donating molecules, including latanoprostene bunod in market and some other candidate compounds, for the intervention of glaucoma, as well as prospects and challenges ahead in this field.

Intraocular pressure lowering efficacy and safety of travoprost 0.004 % as a replacement therapy in patients with open angle glaucoma or ocular hypertension

Background Travoprost has been widely used for the treatment of patients with open-angle glaucoma （OAG） or ocular hypertension （OH）. The aim of this study was to evaluate the intraocular pressure （lOP） lowering efficacy of travoprost 0.004% monotherapy in patients previously treated with other topical hypotensive medications, and in previously untreated patients. Methods This open-label, 12-week study in 1651 adult patients with ocular hypertension or open-angle glaucoma who were untreated or required a change in therapy （due to either inadequate efficacy or safety issues） as judged by the investigator was conducted at 6 sites in China. Previously treated patients were instructed to discontinue their prior medications at the first visit. All the patients were dosed with travoprost 0.004% once-daily at 8 p.m. in both eyes for 12 weeks. Efficacy and safety evaluations were conducted at week 4 and 12. lOP measurements were performed at the same time of day at the follow-up visits. Results For patients transitioned to travoprost, mean lOP reductions from baseline in untreated and treated patients with different prior medications at week 12 were： latanoprost, （4.3±4.6） mmHg; β-blocker, （6.3±4.0） mmHg; α-agonist, （7.5±4.3） mmHg; topical carbonic anhydrase inhibitors, （8.0±4.9） mmHg. All mean lOP changes from baseline were statistically significant （P 〈0.001）. No treatment-related serious adverse events were reported in this study. Conclusions In patients treated with other hypotensive medications or untreated, the lOP reduction with travoprost was significant. The results of this study demonstrated the potential benefit of using travoprost as a replacement therapy in order to ensure adequate lOP control. Travoprost administered once daily was safe and well tolerated in patients with glaucoma or ocular hypertension.