Sihota R, Saxena R, Agarwal H C, Pandey R M, Gulati V
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Eur J Ophthalmol. 2003 Jul;13(6):546-52. doi: 10.1177/112067210301300607.
To compare the diurnal efficacy and action on peak intraocular pressures (IOP) of 0.005% latanoprost and 0.5% timolol as primary therapy in 60 eyes having dark brown irides with primary open angle glaucoma (POAG).
A prospective, comparative, observer-masked, crossover, interventional trial including the mean of both eyes of 30 patients with POAG who were randomly started on either latanoprost once daily or timolol twice daily. Three months after treatment with one drug, the second drug was substituted. A masked observer carried out diurnal assessments of IOP before the start of therapy and at 3 and 7 months. The fourth month was the washout period for the first drug.
The average baseline IOP was 23.36 +/- 2.14 mm Hg, which was reduced by 8.8 +/- 2.2 mmHg with latanoprost (p < 0.01) and by 6.75 +/- 1.9 mm Hg with timolol (p = 0.01). The reduction was greater for latanoprost (p < 0.005). The average peak IOP at baseline was 27.6 +/- 2.22 mmHg. The effective fall in IOP at the time of new peaks in subsequent diurnal recordings of IOP compared to the baseline diurnal curve was 8.9 mm Hg with latanoprost (p < 0.005) and 5.77 mm Hg with timolol (p < 0.01). This difference in IOP reduction between the two drugs was statistically significant (p < 0.01). Latanoprost had a lower efficacy in peak IOP reduction in eyes with evening peak of IOP than in those with morning peak (p < 0.005). The efficacy of timolol was lower overall compared to latanoprost, but was similar in all circadian rhythms. The shift in timing of IOP peak was greater with latanoprost compared to timolol (4.34 hours vs -0.72 hours, p < .01). A total of 90% of patients on latanoprost and 33.3% on timolol achieved a reduction of > 30% in baseline mean IOP. The average of the trough IOP recorded in each of the individual baseline IOP curves was 19.05 +/- 2.05 mm Hg.
Greater mean and peak IOP reduction was achieved with latanoprost compared to timolol. Dampening of the circadian rhythm was better with latanoprost. Latanoprost appears to be more effective than timolol at all points in time with greater efficacy in eyes with morning peaks compared to evening peaks.
比较0.005%拉坦前列素和0.5%噻吗洛尔作为原发性治疗药物，对60只患有原发性开角型青光眼（POAG）且虹膜呈深褐色眼睛的昼夜疗效及对眼压峰值的作用。
一项前瞻性、对比性、观察者盲法、交叉、干预性试验，纳入30例POAG患者双眼的平均值，这些患者被随机分为每日一次使用拉坦前列素组或每日两次使用噻吗洛尔组。使用一种药物治疗3个月后，更换为第二种药物。一名盲法观察者在治疗开始前以及治疗3个月和7个月时进行眼压的昼夜评估。第4个月为第一种药物的洗脱期。
平均基线眼压为23.36±2.14 mmHg，使用拉坦前列素后降低了8.8±2.2 mmHg（p<0.01），使用噻吗洛尔后降低了6.75±1.9 mmHg（p = 0.01）。拉坦前列素的降低幅度更大（p<0.005）。基线时平均眼压峰值为27.6±2.22 mmHg。与基线昼夜曲线相比，在随后眼压昼夜记录出现新峰值时，拉坦前列素使眼压有效下降8.9 mmHg（p<0.005），噻吗洛尔使眼压有效下降5.77 mmHg（p<0.01）。两种药物在眼压降低方面的差异具有统计学意义（p<0.01）。拉坦前列素在眼压峰值出现在晚上的眼中降低眼压峰值的疗效低于眼压峰值出现在早上的眼（p<0.005）。总体而言，噻吗洛尔的疗效低于拉坦前列素，但在所有昼夜节律中相似。与噻吗洛尔相比，拉坦前列素使眼压峰值出现时间的偏移更大（4.34小时对-0.72小时，p<.01）。使用拉坦前列素的患者中有90%、使用噻吗洛尔的患者中有33.3%的基线平均眼压降低>30%。在每个个体基线眼压曲线中记录的谷值眼压平均值为19.05±2.05 mmHg。
与噻吗洛尔相比，拉坦前列素使眼压平均值和峰值降低幅度更大。拉坦前列素对昼夜节律的抑制作用更好。拉坦前列素在所有时间点似乎都比噻吗洛尔更有效，在眼压峰值出现在早上的眼中比出现在晚上的眼疗效更高。
