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Lanza M, Leone A, Scognamiglio G, Serra L, Iodice CM, Melillo P, Simonelli F. Evaluation of the Efficacy Duration of Topical Therapies in Eyes with Primary Open-Angle Glaucoma. J Clin Med 2022; 11:jcm11206166. [PMID: 36294484 PMCID: PMC9605467 DOI: 10.3390/jcm11206166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/09/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background: To investigate the efficacy interval of the topical therapies available for primary open-angle glaucoma (POAG) and the ocular and systemic features potentially associated. Methods: This retrospective study included 190 patients with POAG undergoing first topical therapy, throughout a follow-up of 15 years. The patients started one topical intraocular pressure (IOP)-lowering drug within single molecules such betablockers, prostaglandin or dorzolamide, or fixed combinations such as betablockers + prostaglandin, betablockers + dorzolamide, or betablockers + brimonidine. Efficacy duration was measured as the time between the start of the therapy and the change due to IOP increase or visual field worsening. For each patient, ocular and systemic features and comorbidities were analysed to detect any significant correlation with the length of effectiveness of every drug used. Results: The molecules explored showed some discrepancies in terms of mean duration of efficacy; however, no significant differences were demonstrated (p > 0.05). Furthermore, when evaluating the overall cohort, no systemic or ocular features correlated significantly with the effectiveness of the molecules explored. However, the same analysis carried out upon stratifying the different groups according to the IOP-lowering drops they received, demonstrated that the drug efficacy could be influenced by several ocular and systemic features. Conclusion: Data observed in this study suggest that there is no difference in using one of the medications evaluated as first choice of treatment of POAG if the patients are accurately evaluated and the most recent guidelines are adopted.
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Tekeli O, Köse HC. Evaluation of the Use of Brinzolamide-Brimonidine Fixed Combination in Maximum Medical Therapy. Turk J Ophthalmol 2022; 52:262-269. [PMID: 36017234 PMCID: PMC9421937 DOI: 10.4274/tjo.galenos.2021.25488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Fineide F, Lagali N, Adil MY, Arita R, Kolko M, Vehof J, Utheim TP. Topical glaucoma medications – Clinical implications for the ocular surface. Ocul Surf 2022; 26:19-49. [DOI: 10.1016/j.jtos.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/25/2022]
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Inoue K, Komori R, Kunimatsu-Sanuki S, Ishida K, Tomita G. Frequency of Use of Fixed-Combination Eye Drops by Patients with Glaucoma at Multiple Private Practices in Japan. Clin Ophthalmol 2022; 16:557-565. [PMID: 35256838 PMCID: PMC8898178 DOI: 10.2147/opth.s345944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/28/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the current use of fixed-combination eye drops by patients with glaucoma in Japan. Patients and Methods A total of 5303 outpatients (5303 eyes) with glaucoma or ocular hypertension were enrolled in the survey at 78 private practices from March 8 to 14, 2020. The medications they used were investigated. The use of fixed-combination medications was analyzed, stratified by the number of medications used. The results were compared to those of the survey performed in 2016 via χ2 tests. Results Fixed-combination medications were used by 55.6%, 79.8%, 84.9%, 91.3%, and 94.1% of patients in the two-, three-, four-, five, and six-medications groups. The use of prostaglandin analog/β-blocker (PG/β), carbonic anhydrase inhibitor/β-blocker (CAI/β), and α-2-adrenergic agonist/β-blocker (α2/β) fixed-combination medications were 42.8%, 12.0%, and 0.8% in the two-medications group; 36.2%, 41.6%, and 2.0% in the three-medications group; and 23.5%, 60.1%, and 1.3% in the four-medications group, respectively. The most commonly used fixed-combination medications were PG/β in the two-medications group and CAI/β in the groups using three or more medications. Compared to those in the survey performed in 2016, there were increases (both P < 0.0001) in the use of PG/β fixed-combination medication in the two- (28.7% to 42.8%) and three-medications (21.7% to 36.2%) groups, and none in the use of CAI/β fixed-combination medication. There was little use of α2/β fixed-combination medication, probably because it was launched only three months before the survey. Conclusion The proportion of fixed-combination medications increased as the number of medications per patient increased.
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Affiliation(s)
- Kenji Inoue
- Inouye Eye Hospital, Tokyo, Japan
- Correspondence: Kenji Inoue, Inouye Eye Hospital, 4-3 Kanda-surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan, Tel +813-3295-0911, Fax +813-3295-0917, Email
| | | | | | - Kyoko Ishida
- Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Goji Tomita
- Inouye Eye Hospital, Tokyo, Japan
- Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan
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Fujishiro T, Honjo M, Kawasaki H, Aihara M. Visual cortex damage in a ferret model of ocular hypertension. Jpn J Ophthalmol 2022; 66:205-212. [PMID: 35044565 DOI: 10.1007/s10384-022-00901-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE We aimed to analyze the changes in the visual cortex of a ferret model of ocular hypertension (OH) using cytochrome oxidase (CO) staining. STUDY DESIGN Experimental. METHODS OH was induced in 9 ferrets by means of injection of cultured conjunctival cells into the anterior chamber of the right eye. Three ferrets were used as the controls. CO staining was performed to assess the metabolic intensity at the II-III and IVC layers of the visual cortex. RESULTS The intensities of CO staining in the right and left II-III layers of the primary visual cortex (V1) in the OH ferrets were 39.8 ± 10.3 and 41.9 ± 9.2 arbitrary units, respectively. In the control ferrets, the intensity was 88.1 ± 8.1 arbitrary units. The intensity of CO staining of the II-III layers obtained from the OH eyes was significantly lower than that from the control eyes (unpaired t test, P < .01). The intensities of CO staining in the right and left IVC layers of V1 in the OH ferrets were 60.3 ± 12.8 and 60.0 ± 13.5 arbitrary units, respectively. In the control ferrets, the intensity was 111.4 ± 9.6 arbitrary units. The CO staining intensity of the IVC layer obtained from the OH eyes was significantly lower than that from the control eyes (unpaired t test, P < .01). CONCLUSION The CO staining intensity was reduced in the visual cortex from OH eyes. This study revealed that OH causes metabolic change in the visual cortex.
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Affiliation(s)
- Takashi Fujishiro
- Department of Ophthalmology, University of Tokyo School of Medicine, 7-3-1 Hongo Bunkyoku, Tokyo, 113-8655, Japan
| | - Megumi Honjo
- Department of Ophthalmology, University of Tokyo School of Medicine, 7-3-1 Hongo Bunkyoku, Tokyo, 113-8655, Japan
| | - Hiroshi Kawasaki
- Department of Medical Neuroscience, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawashi, Kanazawa, Japan
| | - Makoto Aihara
- Department of Ophthalmology, University of Tokyo School of Medicine, 7-3-1 Hongo Bunkyoku, Tokyo, 113-8655, Japan.
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Park SW, Kim JM, Lee JW, Maglambayan J, Simonyi S, Park KH. Efficacy and safety of fixed-combination brimonidine tartrate/timolol maleate in primary open-angle glaucoma, including normal-tension glaucoma. Jpn J Ophthalmol 2021; 65:295-305. [PMID: 33591471 DOI: 10.1007/s10384-020-00796-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 10/23/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To assess the 12-month efficacy and safety of fixed-combination brimonidine tartrate 0.2%/timolol maleate 0.5% (FCBT) with or without bimatoprost 0.01% (BIM) in primary open-angle glaucoma (POAG), including normal-tension glaucoma (NTG). STUDY DESIGN Prospective, multicenter, open-label study. METHODS FCBT was self-administered twice daily after applicable washout (study eye). Intraocular pressure (IOP) was measured at baseline and months 1, 3, 6, 9, and 12. BIM could be added for IOP ≥ 21 mmHg, IOP reduction from baseline < 20%, or the investigator deemed it necessary. Primary endpoint: mean (11-a.m.) month-12 IOP change from baseline. Secondary endpoints included mean IOP changes from baseline at other visits, median time to achieving and patients (%) achieving target IOP reduction with FCBT, and visual field (VF) progression rate over 12 months. Safety was assessed at each visit. RESULTS Of 118 eyes with POAG (NTG, n = 93), 87 used FCBT; 31 required FCBT + BIM. Mean IOP changes from baseline (16.8 and 15.3 mmHg) to month 12 were - 4.1 mmHg (FCBT, n = 62) and - 3.5 mmHg (FCBT + BIM, n = 15), respectively (both P < 0.0001). Patients who achieved target IOP reduction with FCBT did so in 1 month (median). VF progression rates were 0.17%/year (FCBT, P = 0.8367) and - 0.08%/year (FCBT + BIM, P = 0.9410). Ocular treatment-emergent adverse events occurred in 42.5% (FCBT) and 71.0% (FCBT + BIM) of patients; most were mild and included ocular hyperemia (9.2% and 41.9%, respectively). CONCLUSIONS Despite low mean baseline IOP, ≥ 20% IOP reduction from baseline persisted over 12 months with FCBT and FCBT + BIM, without clinically significant VF progression. Tolerability was consistent with reported drug safety profiles.
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Affiliation(s)
- Sang Woo Park
- Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Woong Lee
- Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Joy Maglambayan
- Medical Affairs, Allergan (an AbbVie company), Singapore, Singapore
| | - Susan Simonyi
- Medical Affairs, Allergan (an AbbVie company), Singapore, Singapore
| | - Ki Ho Park
- Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
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Omoto T, Fujishiro T, Asano-Shimizu K, Sugimoto K, Sakata R, Murata H, Asaoka R, Honjo M, Aihara M. Comparison of 12-month surgical outcomes of ab interno trabeculotomy with phacoemulsification between spatula-shaped and dual-blade microhooks. Jpn J Ophthalmol 2021; 65:402-408. [PMID: 33411098 DOI: 10.1007/s10384-020-00806-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/23/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To compare 12-month clinical results of spatula-shaped and dual-blade microhooks ab interno trabeculotomy with phacoemulsification. STUDY DESIGN Retrospective comparative study. METHODS We conducted a retrospective chart review of Japanese open-angle glaucoma patients who underwent ab interno trabeculotomy with phacoemulsification with a 12-month follow-up. Two types of trabecular hook were used: the spatula-shaped Tanito Trabeculotomy ab interno Micro-hook® and the Kahook Dual Blade®. Changes in intraocular pressure (IOP) and medication scores comprised the main outcome metrics. We also analyzed and compared patient demographics and the occurrence of complications. RESULTS Trabeculotomy was performed using a spatula-shaped hook in 17 eyes and a dual-blade hook in 15 eyes. Significant reductions in IOP (p < 0.001) and medication scores (p < 0.001) were noted in both groups after the 1-month time point. The percentage changes of IOP from baseline at each time point were not significantly different between groups, though there was a significant difference in medication scores at 12 months (p = 0.0192). Postoperative complications occurred similarly in both groups; one case in the dual-blade group required additional filtration surgery. CONCLUSIONS Ab interno trabeculotomy with phacoemulsification was effective in lowering IOP both with spatula-shaped and with double-blade microhooks. At 12 months more medications were used postoperatively in the spatula-shaped microhook group; however, the reductions in the medication scores from baseline were statistically significant in both groups.
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Affiliation(s)
- Takashi Omoto
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Takashi Fujishiro
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
| | - Kimiko Asano-Shimizu
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Koichiro Sugimoto
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Rei Sakata
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Megumi Honjo
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Makoto Aihara
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
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Wy S, Kim YK, Jeoung JW, Park KH, Ha A. Comparison of Two Combinations of Maximum Medical Therapy for Lowering Intraocular Pressure in Primary Open-angle Glaucoma. KOREAN JOURNAL OF OPHTHALMOLOGY 2020; 34:19-26. [PMID: 32037746 PMCID: PMC7010467 DOI: 10.3341/kjo.2019.0094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/23/2019] [Accepted: 09/23/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE We sought to compare the efficacy as well as the safety of two maximum medical therapy combinations applied to lower the intraocular pressure (IOP) in different primary open-angle glaucoma (POAG) age groups. METHODS This was a retrospective, consecutive case series study that included 60 eyes of 60 subjects with POAG, specifically 20 subjects aged 40 to 54 years, 21 aged 55 to 69 years, and 19 aged 70 years or older. All had been treated for at least 12 months with triple maximum medical therapy (TMT; dorzolamide/timolol, brimonidine, and latanoprost) to lower their IOP, which subsequently was changed to double maximum medical therapy (DMT, fixed drug combinations of tafluprost/timolol and brinzolamide/brimonidine). The rate of IOP change and adverse drug reactions were compared amongst the three age groups. RESULTS The mean IOP change at three months after converting from TMT to DMT was -0.65 ± 1.42 mmHg (-3.84% ± 9.31%) among the overall study group, but this finding was not statistically significant (p = 0.108). In the 40 to 54 years and 55 to 69 years groups, the mean IOP change rates were +0.29 ± 0.96 mmHg (+2.40% ± 6.85%, p = 0.087) and -0.50 ± 0.99 mmHg (-3.05% ± 6.40%, p = 0.084) respectively. In the 70 years or older group, the mean IOP change, interestingly, was -1.80 ± 1.46 mmHg (-11.29% ± 9.31%, p < 0.001) and nine (47.4%) of the 19 subjects showed additional IOP reductions of 10% or more after converting from TMT to DMT. In all three age groups, the incidence rate of dry eye was significantly lower for DMT than for TMT (p = 0.031). CONCLUSIONS In POAG patients, DMT was proven to be both effective and safe for lowering the IOP, especially in those 70 years or older group, when compared with the TMT protocol.
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Affiliation(s)
- Seoyoung Wy
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ahnul Ha
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
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