Efficacy and safety of tafluprost in normal-tension glaucoma with intraocular pressure of 16 mmHg or less

The Efficacy and Safety Associated with Switching from Concomitant Brimonidine and Ripasudil, or Brimonidine or Ripasudil Monotherapy to a Fixed Combination of Brimonidine and Ripasudil in Glaucoma Patients

Objectives: The purpose of this study was to investigate switching from brimonidine and ripasudil, and brimonidine or ripasudil, to a fixed combination of brimonidine and ripasudil, and evaluate the associated efficacy and safety in glaucoma patients. Methods: Glaucoma patients undergoing treatment with at least brimonidine and ripasudil (n = 25) or treatment with at least brimonidine or ripasudil (n = 45) were evaluated in this retrospective study. After switching patients taking brimonidine and ripasudil, or brimonidine or ripasudil, to a ripasudil/brimonidine fixed-combination, ophthalmic suspension (RBFC), intra-ocular pressure (IOP), conjunctival hyperemia and superficial punctate keratopathy (SPK) were evaluated before and at 4, 12 and 24 weeks after switching to RBFC. Results: No significant differences in the IOPs were observed after switching from brimonidine and ripasudil to RBFC. However, a significant decrease was observed at 4, 12 and 24 weeks in the baseline IOP, from 17.0 ± 4.4 mmHg to 15.7 ± 3.2 mmHg (p < 0.01), 14.3 ± 3.4 mmHg (p < 0.01) and 14.4 ± 4.1 mmHg (p < 0.01), respectively, after switching from brimonidine or ripasudil to RBFC. No significant changes were noted for the SPK score or conjunctival hyperemia score at any of the visits after switching to RBFC. Conclusions: Throughout the 24-week evaluation period, the IOP was maintained after switching from brimonidine and ripasudil to RBFC. However, there was a significant decrease in the IOP after switching from brimonidine or ripasudil to RBFC. These results demonstrate that RBFC is safe for use in the treatment of glaucoma patients.

Periocular Adverse Reactions to Omidenepag Isopropyl

PURPOSE

To investigate the periocular adverse reactions to omidenepag isopropyl (OMDI).

DESIGN

Nonrandomized comparative clinical study.

METHODS

We enrolled 100 patients (100 eyes) with primary open-angle glaucoma or ocular hypertension who received initial treatment with OMDI or tafluprost in only 1 eye for ≥6 months. Photographs of the eyelids were taken on the day of the participants' visit after ≥6 months of prescription. Subsequently, 3 ophthalmologists individually determined the occurrence of eyelid pigmentation, eyelash growth, and deepening of the upper eyelid sulcus (DUES). Additionally, a questionnaire on the subjective symptoms was administered. Multivariate analysis of baseline data was performed to investigate the factors involved in adverse reactions.

RESULTS

The mean duration of drug administration was 10.2 ± 3.8 and 10.8 ± 4.1 months in the OMDI and tafluprost groups, respectively. The frequencies of eyelid pigmentation, eyelash growth, and DUES were 0.0%, 0.0%, and 2.0%, respectively, in the OMDI group, whereas the corresponding values in the tafluprost group were 4.0%, 32.0%, and 12.0%. The only significant difference was that the OMDI group showed fewer patients with eyelash growth than in the tafluprost group (P < .0001). In the questionnaire, the subjective symptoms of eyelid pigmentation, eyelash growth, and DUES were 8.0%, 2.0%, and 4.0%, respectively, in the OMDI group, whereas the corresponding values in the tafluprost group were 12.0%, 40.0%, and 4.0%, respectively. Multivariate analysis revealed a correlation between the type of drug administered and these adverse reactions (R = 0.38, P = .005).

CONCLUSIONS

The frequencies of periocular adverse reactions to OMDI, ranging from 0% to 2.0%, were lower than those to tafluprost.

Short-Term Efficacy and Safety of Omidenepag Isopropyl in Patients with Normal-Tension Glaucoma

Purpose

To retrospectively evaluate the short-term efficacy of omidenepag isopropyl (EYBELIS 0.002%) by assessing its intraocular pressure (IOP)-lowering capability and safety in patients with normal-tension glaucoma (NTG).

Patients and Methods

Fifty-four NTG patients (54 eyes) who were newly administrated with omidenepag isopropyl were enrolled in the study. The subjects comprised 22 men and 32 women, and the mean age of the subjects was 55.0 ± 14.1 years. The mean deviation value using the Humphrey visual field test program (30–2 SITA Standard) was −5.03 ± 3.38 dB. The following data were retrieved from the medical records and used for retrospective analyses: IOP at baseline 1–2 months and 3–4 months after administration. The frequency of non-responder patients who had less than 10% IOP reduction was evaluated. Patients were observed for adverse reactions and dropouts at each time point.

Results

IOP at baseline, after 1–2 months and after 3–4 months was 15.7 ± 2.6 mmHg, 13.5 ± 2.3 mmHg, and 13.6 ± 2.4 mmHg, respectively. There was a significant decrease in IOP after administration (p<0.0001). Eleven patients (22.4%) were non-responders. Adverse reactions occurred in 4 patients (7.4%), including conjunctival hyperemia in 3 patients (after 1 week, 2 weeks, and 1 month, respectively) and eye pain in 1 patient (after 1 month). Five patients (9.3%) dropped out of the study because of an adverse reaction in 3 patients, insufficient IOP reduction in 1 patient, and discontinuation of follow-up of 1 patient at our institution.

Conclusion

After administration of omidenepag isopropyl, IOP in patients with NTG was significantly decreased. However, adverse reactions occurred in 7.4% of patients.

Ocular hypotensive effects of prostaglandin analogs in Japanese patients with normal-tension glaucoma: a literature review

PURPOSE

This paper aimed to evaluate the intraocular pressure (IOP)-lowering effects of prostaglandin analogs (PGAs) in Japanese patients with normal-tension glaucoma (NTG) by reviewing the current literature.

METHODS

In February 2018, database searches were performed in PubMed, Embase, ProQuest, and the Japanese databases JAPICDOC and JMEDPlus. Studies were sorted into two categories: Category 1 consisted of studies of patients with NTG who reported reduced IOP values and Category 2 consisted of studies of patients with NTG who had IOP values at predosing and a final evaluation point. Search terms included ([unoprostone or latanoprost or travoprost or bimatoprost or tafluprost] and [glaucoma] and [Japan or Japanese]). The weighted ocular hypotensive efficacy was calculated. A scatter plot analysis was performed and a regression equation was calculated for each medication. The fitting of each regression equation was evaluated by the least squares method.

RESULTS

Eleven articles were eligible for Category 1 and 25 articles for Category 2. In the rank order of IOP-lowering efficacy of PGAs, bimatoprost was the strongest and latanoprost the weakest. Travoprost and tafluprost had almost the same level of ocular hypotensive effect, and both were stronger than latanoprost. The scatter plot analysis showed that all PGAs reduced IOP by 15%-20%. At higher IOP (17-18 mmHg), the ocular hypotensive effect was almost the same with latanoprost, travoprost, and tafluprost. In contrast, at lower IOP (12-15 mmHg), the IOP reduction with latanoprost was weaker than with travoprost or tafluprost.

CONCLUSION

This literature review of the ocular hypotensive effects of PGAs in Japanese patients with NTG highlighted that PGAs had different ocular hypotensive effects. Ophthalmologists should understand the IOP-lowering profiles of various PGAs and apply them to patients with NTG on a case-by-case basis.

TRIAL REGISTRATION

UMIN Clinical Trials Registry UMIN000032344.

Tafluprost Ophthalmic Solution 0.0015 %: A Review in Glaucoma and Ocular Hypertension

Tafluprost ophthalmic solution 0.0015 % preserved with benzalkonium chloride (BAK) 0.001 % is available in several Asian countries, including Japan. In pivotal trials, BAK-preserved tafluprost ophthalmic solution 0.0015 % lowered intraocular pressure (IOP) more effectively than placebo in Asian patients with normal-tension glaucoma and was at least as effective as latanoprost ophthalmic solution 0.005 % in Asian patients with primary open-angle glaucoma or ocular hypertension. In other prospective studies in Asian patients with glaucoma or ocular hypertension, tafluprost ophthalmic solution 0.0015 % was at least as effective as latanoprost ophthalmic solution 0.005 % or travoprost ophthalmic solution 0.004 % in terms of IOP lowering, and was considered easier to use and/or store. The efficacy of tafluprost ophthalmic solution 0.0015 % was maintained in the longer term. Tafluprost ophthalmic solution 0.0015 % was generally well tolerated. In conclusion, BAK-preserved tafluprost ophthalmic solution 0.0015 % remains a useful option for the treatment of Asian patients with glaucoma and ocular hypertension.

Comparison study of intraocular pressure reduction efficacy and safety between latanoprost and tafluprost in Japanese with normal-tension glaucoma

Purpose

To evaluate and compare the intraocular pressure (IOP) reduction efficacy and safety between the ophthalmic solutions 0.005% latanoprost (Lat) and 0.0015% tafluprost (Taf) in Japanese patients with normal-tension glaucoma (NTG).

Methods

In this randomized nonmasked study, we prospectively enrolled 30 Japanese NTG patients who had used Lat monotherapy for more than 4 weeks, and randomly divided them into the following two groups: 1) Lat-to-Taf group (LT group) and 2) Taf-to-Lat group (TL group). At the beginning of the study, both groups were switched from initial Lat to Lat or Taf for 12 weeks, and then switched over to the other drug (crossover) for 12 additional weeks. At 0, 4, 12, 16, and 24 weeks, we evaluated each patient’s IOP, conjunctival injection, and corneal epitheliopathy score, and at 0, 12, and 24 weeks, we evaluated their eyelash changes and pigmentation of the eyelids and irises.

Results

The mean IOP of the LT group (15 eyes) was 10.5, 10.6, and 11.1 mmHg, at 0, 12, and 24 weeks, respectively, whereas that of the TL group (15 eyes) was 11.7, 11.1, and 10.5 mmHg at 0, 12, and 24 weeks, respectively. No significant differences were found between the two groups and in the intragroup comparisons. Moreover, no significant differences were found between Lat and Taf in regard to the conjunctival injection score and corneal epitheliopathy score. Eyelash changes and eyelid and iris pigmentation were similar in both groups.

Conclusion

The findings of this study show that Lat and Taf have equivalent efficacy and safety in Japanese patients with NTG.

Nonresponders to Prostaglandin Analogs Among Normal-Tension Glaucoma Patients

PURPOSE

To investigate patients whose intraocular pressure (IOP) did not decrease after treatment using a prostaglandin analog (nonresponders).

METHODS

This was an open-label, retrospective, case series study from a single institution. We retrospectively investigated the mean IOP reduction rates, and the proportions of nonresponders, among normal tension glaucoma (NTG) patients (209 cases, 209 eyes) treated using 1 of 4 prostaglandin analogs: latanoprost (40 patients), travoprost (64 patients), tafluprost (52 patients), or bimatoprost (53 patients). Absolute IOP was compared with pretreatment values for all 4 groups at the first and second visits after commencement of prostaglandin analog monotherapy. The IOP reduction rate was compared between groups. The proportion of nonresponders, defined as patients with IOP reduction rate <10% at both visits, was calculated in each group.

RESULTS

The average IOP had significantly decreased from the pretreatment value at the first visit after treatment; the average IOP reduction rate ranged from 15.3% to 22.6%. The IOP reduction rate in the bimatoprost group was significantly higher than those in the travoprost and tafluprost groups (P < 0.001). We identified 6 nonresponders (15.0%) in the latanoprost group, 9 (14.1%) in the travoprost group, 4 (7.7%) in the tafluprost group, and none (0.0%) in the bimatoprost group; nonresponse rates were significantly lower in the bimatoprost group than in the other groups (P ≤ 0.05).

CONCLUSION

Among NTG patients treated using prostaglandin analogs, from 0% to 15% were classified as nonresponders, depending on the prostaglandin analog used. The proportion of nonresponders was significantly lower in the bimatoprost group.

Twenty-four-hour efficacy of preservative-free tafluprost for open-angle glaucoma patients, assessed by home intraocular pressure (Icare-ONE) and blood-pressure monitoring

PURPOSE

To evaluate the effect of preservative-free (PF) tafluprost on diurnal variation of intraocular pressure (IOP) and ocular perfusion pressure (OPP), measured by use of home IOP and blood-pressure (BP) monitoring devices, for primary open angle glaucoma (POAG) patients.

METHODS

Twenty-two eyes from 22 patients with POAG were studied. Initially, IOP was measured at the hospital by Goldmann applanation tonometry (GAT) and Icare-ONE rebound tonometry. Each patient was then instructed how to use the Icare-ONE and BP home monitoring devices. IOP and BP were measured at home by the patients, every 4 h, before and 2 weeks after once daily treatment with PF tafluprost (0.0015%) ophthalmic solution.

RESULTS

Intraclass correlations between different IOP measurements were greater than 0.8. PF tafluprost reduced mean diurnal IOP significantly for patients with POAG, from 15.7 ± 1.2 mmHg at baseline to 12.5 ± 0.6 mmHg 2 weeks after treatment (p < 0.001). It increased mean diurnal OPP from 48.5 ± 7.3 mmHg at baseline to 51.3 ± 7.0 mmHg post-treatment (p < 0.017).

CONCLUSIONS

Icare-ONE enables glaucoma patients to measure their own diurnal IOP fluctuations. Patient-measured Icare-ONE IOP readings showed that PF tafluprost effectively reduced diurnal IOP in eyes with POAG.

Comparison of the toxicity profile of benzalkonium chloride-preserved tafluprost and SofZia-preserved travoprost applied to the ocular surface

PURPOSE

To evaluate some clinically important features of benzalkonium chloride (BAK) toxicity by comparing tafluprost with 0.001% BAK and travoprost preserved with SofZia applied to the ocular surface of the eyes with glaucoma.

METHODS

This was a prospective, randomized, observer unmasked, multicenter crossover trial. A total of 195 patients were randomized and 174 patients completed the study at 19 clinics between November 2011 and August 2012. Topical BAK-preserved tafluprost or SofZia-preserved travoprost was newly administered or continued. Superficial punctate keratopathy (SPK), tear break-up time (BUT), the conjunctival hyperemia score, and intraocular pressure (IOP) were compared at the baseline visit, 4, and 12 weeks after the start of therapy. The eye drops were switched to another eye drop after 12 weeks of observation.

RESULTS

The total SPK and conjunctival hyperemia scores were significantly lower in the tafluprost compared with those in the travoprost phase (both P=0.038). There were no significant differences in the SPK scores of the superior area (P=0.679), central area (P=0.089), inferior area (P=0.090), and tear BUT (P=0.271). The IOP-lowering effects were similar (P=0.155).

CONCLUSIONS

SPK, hyperemia score, and tear BUT while using tafluprost with 0.001% BAK were not inferior compared with those caused by travoprost with SofZia.

The efficacy and safety of add-on 0.1% brimonidine tartrate preserved with sodium chlorite in on-treatment Japanese normal-tension glaucoma patients

Background

To evaluate the efficacy and safety of newly formulated brimonidine (0.1% brimonidine tartrate preserved with sodium chlorite: brimonidine) as add-on therapy in on-treatment Japanese normal-tension glaucoma (NTG) patients.

Methods

Brimonidine was added to on-treatment NTG patients with intraocular pressures (IOP) of between 13 mmHg and 16 mmHg after three consecutive IOP measurements. The time courses of IOP, conjunctival hyperemia, superficial punctate keratitis, and adverse events were examined at 4, 8, and 12 weeks after brimonidine instillation.

Results

Though 75 of 83 patients (31 males and 52 females; mean age: 63.4±11.6 years) completed the study, six patients discontinued because of side effects and two patients withdrew. The mean IOP after brimonidine addition at week 4 (12.6±1.8 mmHg, P<0.001), week 8 (12.4±1.7 mmHg, P<0.001), and week 12 (12.6±1.8 mmHg, P<0.001) was significantly decreased compared with that before the addition of brimonidine (13.9±1.2 mmHg). No significant changes in superficial punctate keratitis or conjunctival hyperemia scores were observed throughout the study. Dizziness, sleepiness, eye pain, and itching (mild to moderate) were noted in five, four, three, and three patients, respectively.

Conclusions

The addition of newly formulated brimonidine to on-treatment Japanese NTG patients with IOP of 13–16 mmHg further reduced the levels of IOP with minimal side effects and adverse events.

Prospective observational post-marketing study of tafluprost for glaucoma and ocular hypertension: short-term efficacy and safety

INTRODUCTION

This study investigated the intraocular pressure (IOP)-lowering effects and safety of tafluprost ophthalmic solution 0.0015% in actual clinical practice.

METHODS

We started a mandatory prospective 2-year observational study, which collected IOP, conjunctival hyperemia score, corneal staining score, and adverse event data from glaucoma and ocular hypertension (OH) patients not previously treated with tafluprost at 2, 12, and 24 months. This report analyzes the 2-month findings.

RESULTS

Of the 4,180 patients from 553 medical institutions in Japan, most patients had primary open-angle glaucoma (POAG, 38.1%) or normal-tension glaucoma (NTG, 44.2%). After 2 months of tafluprost administration, IOP was significantly reduced by 4.3 ± 5.2 mmHg in POAG, 2.4 ± 2.5 mmHg in NTG, 3.6 ± 5.3 mmHg in primary angle-closure glaucoma, 5.6 ± 7.1 mmHg in other types of glaucoma, and 5.3 ± 4.8 mmHg in OH. IOP was significantly reduced by 4.3 ± 4.0 mmHg in the naïve monotherapy group, 1.9 ± 3.5 mmHg in switching from prior treatment, and 3.7 ± 4.1 mmHg in the add-on therapy group. Among patients switched, the prostaglandin analog (PGA) latanoprost was the previous predominant drug (57.4%), followed by travoprost (13.8%). Significant IOP reductions were observed by 1.5 ± 3.4 mmHg in switching from latanoprost and 1.3 ± 3.7 mmHg in switching from travoprost. The conjunctival hyperemia score peaked at 1 month in the naïve monotherapy and add-on therapy groups, whereas it was significantly decreased in patients switched from another PGA. The corneal staining score showed no particular changes. Incidence of adverse drug reaction (ADR) was 7.70 % (322/4,180 patients), and all major ADRs involved the eyes or skin around the eyes.

CONCLUSION

Tafluprost showed significant IOP-lowering effects without any safety concerns in patients with various types of glaucoma and OH in daily clinical practice and tafluprost is highly effective in any therapeutic patterns.

Travoprost with sofZia® preservative system lowered intraocular pressure of Japanese normal tension glaucoma with minimal side effects

Background

This study aimed to evaluate the effect of travoprost with sofZia® preservative system for lowering the intraocular pressure (IOP) of Japanese normal tension glaucoma (NTG) patients.

Methods

In this prospective, multicenter, open-label study, Japanese NTG patients with baseline IOPs <20 mmHg were enrolled after three consecutive time measurements taken at screening and baseline visits. Travoprost with sofZia® was instilled once daily. Lowering effect on IOP, conjunctival hyperemia, superficial punctate keratopathy, and adverse events were examined at week 4, 8, and 12 after drug instillation.

Results

One-hundred and three of the 107 enrolled patients (baseline IOP =15.2±2.0 mmHg [mean ± standard deviation]) completed the study. The mean IOP value as well as percent reduction was significantly reduced at each visit after travoprost with sofZia® initiation (P<0.0001). The conjunctival hyperemia score was 1 or less throughout the study, though it increased significantly over time. No significant change was observed in superficial punctate keratopathy. The cumulative incidence of side effects such as eyelash changes, eyelid pigmentation, and deepening of the upper lid was 47.6%, 27.2%, and 16.5%, respectively.

Conclusion

Travoprost preserved with sofZia® effectively lowered the IOP of Japanese NTG patients. It was well tolerated with few discontinuations due to adverse events.

Incidence of deepening of the upper eyelid sulcus on treatment with a tafluprost ophthalmic solution

PURPOSE

Deepening of the upper eyelid sulcus (DUES), one symptom of prostaglandin-associated periorbitopathy, was recently found to be an additional side effect of prostaglandin-related ophthalmic solutions. Here, we prospectively investigated the incidence and factors associated with DUES in Japanese open-angle glaucoma patients initially treated with benzalkonium chloride (BAK)-preserved tafluprost (TAF).

METHODS

In this open-label prospective study instilling TAF in one eye, mean deviation (MD) and intraocular pressure (IOP) were measured, and facial photographs and subjective reports of DUES were obtained at intervals over 6 months. Three ophthalmologists independently assessed the photographs of DUES and reached consensus. Relationships between demographic and ocular/systemic factors (age, sex, MD, refraction and IOP reduction) and DUES occurrence were evaluated.

RESULTS

Forty-three eyes of 43 glaucoma patients (24 men and 19 women) were evaluated. Mean IOP before treatment was 16.6 ± 2.7 and after treatment, 14.1 ± 2.3 mmHg (P < 0.001). The objective rate of DUES was 9 % (4/43) at 2 months, 14 % (6/43) at 4 months and 14 % (6/43) at 6 months. During this period, only one patient self-reported an occurrence of DUES. No significant association was found between DUES occurrence and any of the demographic, ocular, or systemic factors.

CONCLUSIONS

Physicians should inform patients about DUES as a minor side effect when prescribing TAF for IOP control.

Effects of tafluprost treatment for 3 years in patients with normal-tension glaucoma

Purpose

To evaluate the effects of tafluprost treatment for 3 years on intraocular pressure (IOP) and visual field performance.

Methods

The IOP of 55 patients with normal-tension glaucoma was monitored every 1–3 months for 3 years. The Humphrey visual field test was performed every 6 months after treatment and results compared with before-treatment results. Visual field performance was also evaluated by trend and event analysis.

Results

After 3 years’ tafluprost single-use vials treatment, the IOP (12.8 ± 2.8 mmHg [mean ± standard deviation]) was significantly lower than before treatment (15.7 ± 2.2 mmHg; P < 0.0001). When comparing before-treatment Humphrey visual field test findings with those after 3 years of treatment, no change was found in the mean deviation and pattern standard deviation. Visual field performance had worsened in four patients and three patients according to trend analysis and event analysis, respectively. Adverse reactions appeared in ten cases and one patient (1.8%) discontinued treatment due to an adverse reaction.

Conclusion

Tafluprost single-use vials treatment was effective in reducing IOP over the 3 years of this study, but visual field performance worsened by 10.3%–13.8% in patients with normal-tension glaucoma. Safety was satisfactory.

Tafluprost once daily for treatment of elevated intraocular pressure in patients with open-angle glaucoma

Glaucoma is a leading cause of visual loss worldwide. Current antiglaucoma therapy focuses on lowering intraocular pressure to a safe level. In recent years, prostaglandin analogs have become the first-line agents for treating open angle glaucoma. Tafluprost, which was first reported in 2003, is a novel prostaglandin analog, and has been shown to be a potent ocular hypotensive agent in a number of preclinical and clinical studies. Also, its unique preservative-free formulation helps to decrease preservative-associated ocular disorders and improve patient compliance. In this review, studies from 2003 to 2012 focusing on the structure, metabolism, efficacy, and safety of tafluprost are summarized. These studies suggested that application of tafluprost once daily is a safe and effective treatment for patients with open angle glaucoma.

One Year of Glaucoma Research in Review: 2011 to 2012

PURPOSE

To provide the practicing clinical ophthalmologist with an update of pertinent glaucoma literature published over the past 12 months.

METHODS

The authors conducted a one year (July 1, 2011 to June 30, 2012) English language glaucoma literature search on Pubmed using the following terms: automated perimetry, optic nerve imaging, optical coherence tomography, glaucoma structure and function, intraocular pressure, central corneal thickness, medical therapy and compliance in glaucoma, glaucoma laser treatment, cataract extraction and intraocular pressure, secondary glaucoma, glaucoma surgery, pediatric glaucoma, molecular biology in glaucoma, and miscellaneous topics in glaucoma.

DESIGN

Literature review.

RESULTS

This review includes original and review articles that reflect novel aspects and updates in the field of glaucoma, while excluding letters to the editor, unpublished works, and abstracts.

CONCLUSIONS

This review is not meant to be all-inclusive-rather, it highlights literature that is most applicable to ophthalmologists in practice.

Bimatoprost ophthalmic solution 0.03% lowered intraocular pressure of normal-tension glaucoma with minimal adverse events

Purpose

The aim of this study was to evaluate the efficacy and safety of bimatoprost ophthalmic solution 0.03% (bimatoprost) in Japanese normal-tension glaucoma (NTG) patients with an intraocular pressure (IOP) of 18 mmHg or less.

Methods

Bimatoprost was instilled into the unilateral conjunctival sac of Japanese NTG patients with a baseline IOP of 18 mmHg or less. The time courses of IOP, conjunctival hyperemia, superficial punctate keratitis, and adverse events were examined at 2, 4, 8, and 12 weeks post bimatoprost instillation.

Results

Thirty-two of the 38 enrolled NTG patients (mean age, 64.1 ± 12.6 years; 19 males and 19 females) completed the study, with six patients unable to complete the study (two patients discontinued because of side effects and four patients withdrew). The levels of IOP in the treated eyes were significantly reduced (P < 0.0001) from the baseline IOP levels. No significant change in IOP was observed in the fellow eyes. There were significant increases in conjunctival hyperemia. No significant superficial punctate keratitis scores were noted between the baseline and each point examined. Eyelash disorder, eyelid pigmentation, and deepening of the upper eyelid sulcus were observed in 28, six, and three eyes, respectively.

Conclusion

Bimatoprost effectively lowered the IOP. It was well tolerated in Japanese NTG patients, with few patients having to discontinue because of adverse events.