STUDY ON EFFICACY AND SAFETY OF RIPASUDIL HYDROCHLORIDE IN TREATMENT OF NEWLY DIAGNOSED PRIMARY OPEN ANGLE GLAUCOMA

2021 ◽  
pp. 81-83
Author(s):  
Debalina Ghanta ◽  
Sudeshna Roy ◽  
Taneema Samanta
Keyword(s):  
Adverse Effects ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Coiled Coil ◽  
Ophthalmic Solution ◽  
Primary Treatment ◽  
Current Treatment ◽  
Open Angle ◽  
Newly Diagnosed ◽  
Dence Interval

Aim: The study aims at evaluating the lowering effect of Intraocular pressure (IOP) and tolerability of Ripasudil(0.4%) ophthalmic solution, a selective rho kinase1 inhibitor, as monotherapy in newly diagnosed primary open angle glaucoma patients. Background: Glaucoma is a chronic progressive optic neuropathy causing irreversible blindness around the world. Current treatment strategy stems from concept of lowering IOP, which is a key modiable risk factor. Ripasudil also known as K 115,is the world's rst Rho-associated coiled-coil-containing protein Kinase 1(ROCK1) inhibitor that lowers IOP by directly acting on trabecular meshwork,increasing conventional outow. Methods: This prospective, interventional study included 53 patients of newly diagnosed primary open angle glaucoma.0.4% Ripasudil ophthalmic solution was instilled twice a day as the primary treatment. The primary endpoint was the degree of IOPreduction after 6 months of treatment, whereas the secondary end points were percentage of patients reaching the predened target IOP and incidence of adverse effects. Results: We examined 53 eyes of 53 primary open angle glaucoma patients. The IOP reduction (relative percentage IOP reduction)from baseline was -2.3 mm Hg(-1.7 to -2.9 mm Hg,95%condence interval ,P<0.001).The predetermined target IOPwas achieved by 54.7% population(29 among 53 patients).The most common adverse effects noted were conjunctival hyperaemia (54.7% of patients),allergic conjunctivitis(35.8% of patients) punctate keratitis(11.32% of patients), blepharitis(15.09% of patients), headache(24.5% of patients), bradycardia(9.43% of patients). Conclusion: Administration of 0.4% Ripasudil ophthalmic solution monotherapy revealed IOPlowering effect and acceptable safety prole in POAG patients. As ROCK inhibitors are novel anti-glaucoma drug, more data and studies are needed to establish best practices for the treatment of the patients.

scholarly journals Influence of BAK-Preserved Prostaglandin Analog Treatment on the Ocular Surface Health in Patients with Newly Diagnosed Primary Open-Angle Glaucoma

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Martina Tomić ◽  
Snježana Kaštelan ◽  
Kata Metež Soldo ◽  
Jasminka Salopek-Rabatić
Keyword(s):  
Intraocular Pressure ◽  
Ocular Surface ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Final Visit ◽  
Open Angle ◽  
Newly Diagnosed ◽  
Prostaglandin Analog ◽  
Ocular Surface Health

Purpose. Primary open-angle glaucoma (POAG), a chronic, degenerative optic neuropathy, requires persistent decrease of intraocular pressure so as to prevent visual impairment and blindness. However, long-term use of topical ocular medications may affect ocular surface health. Purpose of this study was to evaluate the influence of BAK-preserved prostaglandin analog treatment on the ocular surface health in patients with newly diagnosed POAG.Methods. 40 newly diagnosed POAG patients were included in this prospective study. Intraocular pressure (IOP), tear break-up time (TBUT), and ocular surface disease index (OSDI) were assessed at baseline and 3-month after starting treatment with BAK-preserved travoprost 0.004%.Results. IOP decreased in all patients from baseline to 3-month final visit (23.80 ± 1.73 mmHg versus 16.78 ± 1.27 mmHg;P<0.001). Mean TBUT decreased from11.70±1.86seconds at baseline to 8.30 ± 1.29 seconds at 3-month final visit (<0.001). Mean OSDI score increased from 31.63 ± 18.48 to 44.41 ± 16.48 (P<0.001).Conclusions. This study showed that BAK-preserved travoprost 0.004% is an effective medication in newly diagnosed POAG patients, but its long-term use may negatively influence ocular surface health by disrupting the tear film stability. Further studies are needed to better understand the clinical effects of different preservative types and concentrations on the ocular surface.

Managing Primary Open-angle Glaucoma – Ocular Tolerability, Compliance, Persistence and Patient Outcomes

2009 ◽  
Vol 03 (01) ◽  
pp. 19 ◽  
Author(s):  
Anton Hommer ◽  
Keyword(s):  
Adverse Effects ◽  
Patient Compliance ◽  
Vision Loss ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Tolerability Profile ◽  
Eye Drops ◽  
Open Angle ◽  
The Individual ◽  
Ocular Tolerability

Primary open-angle glaucoma (POAG) is a progressive optic neuropathy that, left untreated, can lead to irreversible damage to the optic nerve and permanent vision loss. To date, intraocular pressure (IOP) is the only modifiable risk factor for disease progression, and topical eye-drops are currently used as the leading non-surgical glaucoma therapy. Despite the efficacy of pharmacotherapy in lowering IOP, success is ultimately defined by patient compliance and patient persistence. Ocular tolerability is a crucial factor in patient compliance and persistence; non-adherence owing to adverse effects can lead to poor control of IOP and treatment failure. Prostaglandin analogues are currently the first-line antiglaucoma agents, with a good tolerability profile and a better IOP-lowering effect compared with β-blockers. Combination therapies have also shown greater efficacy in lowering IOP compared with the individual constituents, with fewer adverse effects. Treatment should be tailored to the individual patient, with a focus on ocular tolerability and its role in adherence, compliance and vision preservation.

scholarly journals Comparing posture induced intraocular pressure variations in normal subjects and glaucoma patients

2021 ◽  
Vol 14 (3) ◽  
pp. 399-404
Author(s):  
Onyekachi Jane Ireka ◽  
◽  
Obinna C Arinze ◽  
Nneka Ogbu ◽  
Chimdi M Chuka-Okosa ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Normal Subjects ◽  
University Teaching ◽  
Sitting Position ◽  
Open Angle ◽  
Newly Diagnosed ◽  
Matched Study ◽  
Eye Clinic

AIM: To compare the posture-induced variations in intraocular pressure (IOP) between the primary open angle glaucoma (POAG) and non-glaucomatous eyes. METHODS: A case-controlled age matched study was conducted in 55 successive newly diagnosed POAG and 56 non-glaucomatous patients seen in glaucoma clinic and general outpatient eye clinic in the Alex Ekwueme University Teaching Hospital, Abakaliki. The IOPs of eligible correspondents were measured with Perkin's hand-held tonometer in the sitting, supine flat and supine with pillow positions respectively. Measurement of IOP in each position was done after 15min of assuming such posture. RESULTS: The IOP difference between the sitting and supine flat position was significantly higher in the POAG than non-glaucoma subjects (7.68±2.08 vs 4.03±0.13 mm Hg, P<0.001). The IOP difference between the sitting and supine with pillow positions was 2.61±1.49 mm Hg for POAG and 1.44±0.70 mm Hg in non-glaucoma (P<0.001), while difference between supine flat and supine with pillow positions was 5.07±2.24 mm Hg in POAG and 2.59±0.66 mm Hg in non-glaucomatous patients (P<0.001). CONCLUSION: Greater variations in posture induced IOP occurred in POAG patients than non-glaucomatous. The posture induced IOP variation is lowest in the sitting position and highest in the supine flat position. Evaluation of posture induced IOP changes may be an important tool in the management of glaucoma.

scholarly journals Efficacy and Safety of Timolol-Dorzolamide Fixed-Combination Three Times a Day Versus Two Times a Day in Newly Diagnosed Open Angle Glaucoma

2018 ◽  
Author(s):  
Mohammad Pakravan ◽  
Afsaneh Naderi Beni ◽  
Shahin Yazdani ◽  
Hamed Esfandiari
Keyword(s):  
Blood Pressure ◽  
Primary Open Angle Glaucoma ◽  
Fixed Combination ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Open Angle ◽  
Newly Diagnosed ◽  
Efficacy And Safety ◽  
The Mean

Purpose: To compare the therapeutic efficacy and safety of dorzolamide/timolol fixed-combination in newly diagnosed primary open angle glaucoma patients. Methods: In this prospective, interventional case series, newly diagnosed primary open angle glaucoma (POAG) patients that had not been treated for glaucoma were included. Patients were started on Cosopt twice a day (BID) for 1 month and then switched to three times a day (TDS) for additional 1 month. Patients underwent comprehensive ophthalmic examination, diurnal intraocular pressure (IOP), blood pressure (BP) and 24-hours heart rate (HR) measurements at baseline, month 1( BID), and month 2( TDS). IOP, systolic and diastolic pressures were measured at 8:00 AM,12:00 AM, 4:00 PM, 8:00 PM and 12:00 PM. Throughout the study, all adverse events were recorded and monitored by the investigators. Results: In 31 POAG patients that completed the study ,mean baseline IOP was 23.1&plusmn;3.15 mmHg . IOP was decreased significantly 16.5 &plusmn; 2.21 at 1 month (P &lt; 0.0001) and 13.9 &plusmn; 2.23 mmHg at 1 and 2 month follow up. (P &lt; 0.0001) IOP was significantly lower in month 2 compared to month 1 (P = 0.0004). While Cosopt BID significantly reduced the mean 24-hour systolic BP and mean 24-hour HR from baseline (P &lt; 0.0001), the mean 24-hour systolic BP and HR remained unchanged 2ith Cosopt TDS compared to BID (P = 0.62). Conclusions: Cosopt TDS has a superior IOP-lowering effect than Cosopt BID in POAG patients with comparable safety profile.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;

The clinical features in patients with newly diagnosed pseudoexfoliative glaucoma in Serbia

2019 ◽  
Vol 30 (3) ◽  
pp. 513-524
Author(s):  
Vesna D Maric ◽  
Anita D Grgurevic ◽  
Andja M Cirkovic ◽  
Ivan S Marjanovic ◽  
Marija M Bozic
Keyword(s):  
Intraocular Pressure ◽  
Clinical Features ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Systemic Disease ◽  
Pseudoexfoliation Syndrome ◽  
Mean Deviation ◽  
Open Angle ◽  
Newly Diagnosed ◽  
Pseudoexfoliative Glaucoma

Purpose: To evaluate the clinical characteristics of newly diagnosed pseudoexfoliative glaucoma and compare them with those pertaining to newly diagnosed primary open-angle glaucoma as well as pseudoexfoliation syndrome. Methods: This case–control study involved 306 participants, including patients with newly diagnosed pseudoexfoliative glaucoma, age- and sex-matched normal controls, patients with newly diagnosed primary open-angle glaucoma, and subjects with pseudoexfoliation syndrome. The study was conducted at the Glaucoma Department of Clinic for Eye Diseases, Clinical Center of Serbia, as the referral center for glaucoma in Serbia. Results: The mean age in the pseudoexfoliative glaucoma, primary open-angle glaucoma, pseudoexfoliation syndrome, and normal control groups was 73.61 ± 8.46, 65.50 ± 8.97, 74.81 ± 6.80, and 73.58 ± 9.34 years, respectively (pseudoexfoliative glaucoma vs primary open-angle glaucoma, p < 0.001). Unilateral pseudoexfoliative glaucoma was diagnosed in 35 patients (42.2%). The intraocular pressure was higher in the eyes affected by pseudoexfoliative glaucoma (32.0 ± 9.5 mmHg) than that in the primary open-angle glaucoma eyes (28.8 ± 5.9 mmHg) (p < 0.001). In pseudoexfoliative glaucoma and primary open-angle glaucoma eyes, glaucoma severity was determined via the vertical cup-to-disk ratio (C/D) 0.65 (0.45–1.0) versus 0.60 (0.45–1.0), p = 0.048 and visual field mean deviation −5.68 (−1.58 to −30.9) versus −4.70 (−1.39 to −31.0), p = 0.045. Alzheimer’s was the only systemic disease associated with pseudoexfoliative glaucoma in the study sample, with an odds ratio of 0.021 (95% confidence interval = 0.00−21.52, p = 0.022). Conclusion: At the time of diagnosis, pseudoexfoliative glaucoma exhibits different clinical features compared with primary open-angle glaucoma. Higher intraocular pressure, narrow or occludable angle, increased trabecular pigmentation, phacodonesis, and poorer pupillary dilatation emerged as the factors associated with pseudoexfoliative glaucoma.

Comparison of Two Fixed Beta-Blocker-Pilocarpine Combinations

1997 ◽  
Vol 7 (4) ◽  
pp. 351-356 ◽  
Author(s):  
◽  
A. M. Bron ◽  
C. P. Garcher ◽  
D. Sirbat ◽  
C. M. Allaire ◽  
...  
Keyword(s):  
Ocular Hypertension ◽  
Beta Blocker ◽  
Statistical Difference ◽  
Primary Open Angle Glaucoma ◽  
Fixed Combination ◽  
Open Angle Glaucoma ◽  
Ophthalmic Solution ◽  
Open Angle ◽  
Efficacy And Safety ◽  
Group A

Purpose To compare the efficacy and safety of a newly developed ophthalmic solution containing carteolol 2% and pilocarpine (2% (CBS341A) with a timolol 0.5% and pilocarpine 2% fixed combination. Patients and Methods. A randomized, double-masked, multicenter study was conducted in 209 patients with primary open-angle glaucoma or ocular hypertension, whose intraocular pressure (IOP) was higher than 21 mm Hg on bet-blocker twice a day alone. The test medications were administered twice daily for 4 months. IOP was measured at 9 and 11 a.m. at the beginning of the study (with beta-blocker alone) and after one and four months of treatment. Adverse effects were recorded. Results Both combinations caused a similar, statistically significant decrease in IOP. At four months, in the CBS341A group a 2.4 mm Hg (9%) reduction in IOP was achieved at 9 a.m. and 4.1 mm Hg (17.3%) at 11 a.m. compared with respectively 3 mm Hg (11%) and 4.5 mm Hg (19.5%) in the timolol-pilocarpine group. No statistical difference was observed between the two groups in safety and efficacy. Conclusions The carteolol-pilocarpine combination appears as safe and as effective as the timolol-pilocarpine combination in the medical treatment of primary open-angle glaucoma or ocular hypertension.

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