Comparison of the Effects of Latanoprost, Travoprost, and Bimatoprost on Circadian Intraocular Pressure in Patients with Glaucoma or Ocular Hypertension
Received 22 February 2005; accepted 31 October 2005.
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.
Eye Clinic, Department of Medicine, Surgery and Odontoiatry, University of Milan San Paolo Hospital, Milan, Italy
Reprint requests to Nicola Orzalesi, MD, Department of Medicine, Surgery and Odontoiatry, University of Milan San Paolo Hospital, Via di Rudinì 8, 20142 Milano, Italy.
Manuscript no. 2005-163.
None of the authors has any proprietary interest in any of the drugs or instruments used in the trial.
ABSTRACT