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Heo JY, Ooi YH, Rhee DJ. Effect of prostaglandin analogs: Latanoprost, bimatoprost, and unoprostone on matrix metalloproteinases and their inhibitors in human trabecular meshwork endothelial cells. Exp Eye Res 2020; 194:108019. [PMID: 32222455 DOI: 10.1016/j.exer.2020.108019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/04/2020] [Accepted: 03/19/2020] [Indexed: 01/17/2023]
Abstract
Bimatoprost, latanoprost, and unoprostone are prostaglandin F2α analogs (PGAs) and are used to lower intraocular pressure. We investigated the free acid effects of these three prostaglandin analogs: bimatoprost, latanoprost, and unoprostone on human matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMP) in the trabecular meshwork (TM) cells. Immunoblot results show that all three PGAs generally increased MMPs-1,9 and TIMPs-4. Additionally, bimatoprost and latanoprost both increased MMP-3 and TIMP-2, while unoprostone had an indeterminate effect on both. Zymography results show that all three PGAs except unoprostone increased intermediate MMP-1 activity while bimatoprost and latanoprost increased MMP-9 activity. Together, these data suggest that the balance between MMPs and TIMPs correlate to the relative intraocular pressure lowering effectiveness observed in clinical studies of these PGAs.
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Affiliation(s)
- Jae Young Heo
- Department of Ophthalmology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Yen Hoong Ooi
- Department of Pediatrics, New York Downtown Hospital, 83 Gold Street, New York, NY, 10038, USA
| | - Douglas J Rhee
- Department of Ophthalmology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
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2
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Almeida I, Scoralick ALB, Dias DT, Ushida M, Dorairaj S, Gracitelli CP, Paranhos A, Kanadani FN, Prata TS. Comparison between provocative test-based and long-term intraocular pressure parameters in patients with stable open-angle glaucoma. Eur J Ophthalmol 2020; 31:453-459. [PMID: 32162542 DOI: 10.1177/1120672120911337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To compare provocative test-based and long-term intraocular pressure variation parameters in patients with stable open-angle glaucoma. METHODS A prospective observational study was carried out in which stable open-angle glaucoma patients (⩾3 years of follow-up without any changes on current medical regimen) were consecutively enrolled. All patients were submitted to a water-drinking test. Long-term intraocular pressure parameters were obtained from isolated intraocular pressure measurements from each visit (⩾5 visits). We investigated the correlation and agreement between the following water-drinking test and long-term intraocular pressure parameters: mean, peak, and fluctuation. In addition, the percentage of eyes with significant intraocular pressure peaks during the water-drinking test (defined as a difference ⩾25% between water-drinking test intraocular pressure peak and mean long-term intraocular pressure) was assessed. RESULTS Sixty-three eyes from 63 open-angle glaucoma patients (mean age, 60.7 ± 11.8 years) were included. Mean and water-drinking test intraocular pressure peak correlated significantly with mean (r = 0.67) and maximum long-term intraocular pressure (r = 0.52), respectively (p < 0.01). The correlation between water-drinking test intraocular pressure fluctuation and long-term intraocular pressure fluctuation was not significant (p = 0.45). Limits of agreement from Bland-Altman plots exceeded the maximum allowed difference between methods (3 mm Hg) for all the intraocular pressure parameters analyzed, suggesting poor agreement between water-drinking test-derived and long-term intraocular pressure values. Overall, significant water-drinking test intraocular pressure peaks were observed in 39.7% of these eyes with stable open-angle glaucoma. CONCLUSION Although some water-drinking test-based and long-term intraocular pressure parameters correlate significantly, water-drinking test results may not reflect the long-term intraocular pressure profile of stable open-angle glaucoma patients, as their agreement is poor. Many of these patients may experience significant water-drinking test intraocular pressure peaks, despite long-standing stable disease and unchanged medical regimen.
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Affiliation(s)
- Izabela Almeida
- Glaucoma Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.,Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, Brazil
| | - Ana Luiza B Scoralick
- Glaucoma Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.,Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, Brazil
| | - Diego T Dias
- Glaucoma Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.,Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, Brazil
| | - Michele Ushida
- Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, Brazil
| | - Syril Dorairaj
- Department of Ophthalmology, College of Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Carolina Pb Gracitelli
- Glaucoma Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Augusto Paranhos
- Glaucoma Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Fábio N Kanadani
- Department of Ophthalmology, College of Medicine, Mayo Clinic, Jacksonville, FL, USA.,Department of Ophthalmology, Instituto de Olhos Ciências Médicas, Belo Horizonte, Brazil
| | - Tiago S Prata
- Glaucoma Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.,Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, Brazil.,Department of Ophthalmology, College of Medicine, Mayo Clinic, Jacksonville, FL, USA
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3
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Comparison of Intraocular Pressure Changes During the Water Drinking Test Between Different Fluid Volumes in Patients With Primary Open-angle Glaucoma. J Glaucoma 2018; 27:950-956. [DOI: 10.1097/ijg.0000000000001037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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4
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Razeghinejad MR, Tajbakhsh Z, Nowroozzadeh MH, Masoumpour M. Water Drinking Test: Intraocular Pressure Changes after Tube Surgery and Trabeculectomy. J Ophthalmic Vis Res 2017; 12:390-396. [PMID: 29090048 PMCID: PMC5644405 DOI: 10.4103/jovr.jovr_204_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To study the effects of filtration surgeries (tube and trabeculectomy) on changes in intraocular pressure after a water-drinking test. METHODS In this prospective, non-randomized, comparative clinical study, 30 patients who had tube surgery and 30 age- and sex-matched trabeculectomy patients underwent a water-drinking test. Only one eye of each patient was included. The baseline intraocular pressure was ≤21 mmHg in all enrolled eyes with or without adjunctive topical medications. After the water-drinking test, the intraocular pressure was measured and recorded at 15, 30, 45, and 60 minutes and the results were compared between the two groups. RESULTS In both groups, intraocular pressure significantly increased from baseline at all measured time-points (P < 0.001). In the trabeculectomy group, the average intraocular pressure increased from 14.8 ± 2.9 to 18.8 ± 4.7 mmHg at 30 minutes, but decreased at 60 min (18.0 ± 5.2 mmHg). In the Tube group, intraocular pressure increased incrementally until the last measurement (14.2 ± 3.9, 18.8 ± 5.6, and 19.7 ± 6.0 mmHg at baseline, 30, and 60 minutes, respectively). The end-pressure difference (intraocular pressure at 60 minutes vs. baseline) was significantly greater in the tube group (5.6 ± 3.6 mmHg; 41% change) than in the trabeculectomy group (3.2 ± 4.7; 23% change; P = 0.03). CONCLUSION Intraocular pressure significantly increased after the water-drinking test in both the groups. Intraocular pressure started to decline 30 minutes after the water-drinking test in the trabeculectomy group, while it continued to increase up to 60 minutes in the Tube group. This finding may have implications regarding the efficacy or safety of the procedures in advanced glaucoma patients.
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Affiliation(s)
- Mohammad Reza Razeghinejad
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Glaucoma Service, Wills Eye Hospital, Philadelphia, PA, USA
| | - Zahra Tajbakhsh
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Masoumeh Masoumpour
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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5
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Razeghinejad MR, Tajbakhsh Z, Nowroozzadeh MH, Havens SJ, Ghate D, Gulati V. The Water-Drinking Test Revisited: An Analysis of Test Results in Subjects with Glaucoma. Semin Ophthalmol 2017; 33:517-524. [PMID: 28537521 DOI: 10.1080/08820538.2017.1324039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The Water-Drinking Test (WDT) has been shown to predict the diurnal IOP change. This study evaluates the factors that may affect the WDT results. METHODS This study was conducted on 203 glaucoma patients who had undergone trabeculectomy (53) or tube surgery (31), or had a medically controlled open-angle (82) or closed-angle (37) glaucoma. IOP was measured at baseline and then every 15 minutes over a one-hour period after drinking water. The main outcome measures were IOP change (increase in IOP from baseline) at all measurement time points, IOP peak (highest IOP after drinking water), IOP fluctuation (difference between IOP peak and baseline), and assessing the association of these IOPs with a patient's demographic and management modalities. RESULTS The mean age of the participants was 54±18 years, and 113 (56%) were male. Female patients showed greater IOP fluctuation than males (7.28 vs. 5.92 mm Hg; P=0.016), and a greater IOP peak (22.7 vs. 20.1 mm Hg; P=0.001). The observed associations between gender and IOP changes were only significant in <50 years. IOP at 60 minutes was greater in tube than trabeculectomy (5.6 vs. 3.1 mm Hg; P=0.007). The number of topical medications showed a direct independent association with IOP changes (P<0.001). Compared to other classes of topical medications, latanoprost showed lower WDT-IOP profile (P=0.0003). CONCLUSIONS WDT-IOP change was diminished in subjects on latanoprost, and was greater in females <50 years, and those on greater number of medications.
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Affiliation(s)
- M Reza Razeghinejad
- a Poostchi Eye Research Center , Shiraz University of Medical Sciences , Shiraz , Iran.,b Truhlsen Eye Institute, University of Nebraska Medical Center , Omaha , NE , USA
| | - Zahra Tajbakhsh
- a Poostchi Eye Research Center , Shiraz University of Medical Sciences , Shiraz , Iran
| | | | - Shane J Havens
- b Truhlsen Eye Institute, University of Nebraska Medical Center , Omaha , NE , USA
| | - Deepta Ghate
- b Truhlsen Eye Institute, University of Nebraska Medical Center , Omaha , NE , USA
| | - Vikas Gulati
- b Truhlsen Eye Institute, University of Nebraska Medical Center , Omaha , NE , USA
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6
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Özyol P, Özyol E, Baldemir E. Intraocular pressure dynamics with prostaglandin analogs: a clinical application of the water-drinking test. Clin Ophthalmol 2016; 10:1351-6. [PMID: 27555742 PMCID: PMC4969041 DOI: 10.2147/opth.s108456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the clinical applicability of the water-drinking test in treatment-naive primary open-angle glaucoma patients. METHODS Twenty newly diagnosed primary open-angle glaucoma patients and 20 healthy controls were enrolled in this prospective study. The water-drinking test was performed at baseline and 6 weeks and 3 months after prostaglandin analog treatment. Peak and fluctuation of intraocular pressure (IOP) measurements obtained with the water-drinking test during follow-up were analyzed. Analysis of variance for repeated measures and paired and unpaired t-tests were used for statistical analysis. RESULTS The mean baseline IOP values in patients with primary open-angle glaucoma were 25.1±4.6 mmHg before prostaglandin analog treatment, 19.8±3.7 mmHg at week 6, and 17.9±2.2 mmHg at month 3 after treatment. The difference in mean baseline IOP of the water-drinking tests was statistically significant (P<0.001). At 6 weeks of prostaglandin analog treatment, two patients had high peak and fluctuation of IOP measurements despite a reduction in baseline IOP. After modifying treatment, patients had lower peak and fluctuation of IOP values at month 3 of the study. CONCLUSION Peak and fluctuation of IOP in response to the water-drinking test were lower with prostaglandin analogs compared with before medication. The water-drinking test can represent an additional benefit in the management of glaucoma patients, especially by detecting higher peak and fluctuation of IOP values despite a reduced mean IOP. Therefore, it could be helpful as a supplementary method in monitoring IOP in the clinical practice.
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Affiliation(s)
| | | | - Ercan Baldemir
- Biostatistics Department, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
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7
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Effect of Switching From Latanoprost to Bimatoprost in Primary Open-Angle Glaucoma Patients Who Experienced Intraocular Pressure Elevation During Treatment. J Glaucoma 2016; 25:e359-66. [DOI: 10.1097/ijg.0000000000000376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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8
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Srinivasan S, Choudhari NS, Baskaran M, George RJ, Shantha B, Vijaya L. Diurnal intraocular pressure fluctuation and its risk factors in angle-closure and open-angle glaucoma. Eye (Lond) 2015; 30:362-8. [PMID: 26563660 DOI: 10.1038/eye.2015.231] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 09/23/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate intraocular pressure (IOP) fluctuation during office hours and its predictive factors in untreated primary angle-closure suspects (PACS); post-iridotomy primary angle closure (PAC) and primary angle-closure glaucoma (PACG) eyes with or without IOP-lowering medication(s) as appropriate and medically treated primary open-angle glaucoma (POAG) eyes. METHODS One-hundred seventeen eyes (29 PACS, 30 PAC, 28 PACG, and 30 POAG) of 117 patients were included in this cross-sectional study. The subjects underwent hourly IOP measurements with Goldmann tonometer from 0800 to 1700 hours. Subjects with PAC and PACG had laser peripheral iridotomy at least 2 weeks prior to the inclusion. SD of office-hour IOP readings was the main outcome measure. RESULTS IOP fluctuation differed between the groups (P=0.01; Kruskal-Wallis Test). Post hoc Mann-Whitney U-tests showed significantly less IOP fluctuation in PACS compared with PACG (P<0.01). Peak office-hour IOP was observed in the morning in untreated subjects and in the early afternoon in treated subjects. A stepwise linear regression model identified the presence of peripheral anterior synechiae (PAS), thickness of lens, large vertical cup-to-disc ratio (VCDR), and PAC category as significant predictive factors associated with office-hour IOP fluctuation. CONCLUSIONS Diurnal IOP fluctuation in asymptomatic PACSs was less than that in treated PACG subjects and was at least comparable to that in treated PAC and POAG subjects. The greater the amount of PAS, the thicker the lens, the larger the VCDR, the greater was the IOP fluctuation during office hours.
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Affiliation(s)
- S Srinivasan
- Elite School of Optometry, Medical Research Foundation, Chennai, India.,Jadhavbhai Nathamal Singhvi Glaucoma Department, Medical Research Foundation, Sankara Nethralaya, Chennai, India.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - N S Choudhari
- Jadhavbhai Nathamal Singhvi Glaucoma Department, Medical Research Foundation, Sankara Nethralaya, Chennai, India.,VST Glaucoma Centre, Dr Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India
| | - M Baskaran
- Jadhavbhai Nathamal Singhvi Glaucoma Department, Medical Research Foundation, Sankara Nethralaya, Chennai, India.,Singapore Eye Research Institute and Singapore National Eye Center, Singapore
| | - R J George
- Jadhavbhai Nathamal Singhvi Glaucoma Department, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - B Shantha
- Jadhavbhai Nathamal Singhvi Glaucoma Department, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - L Vijaya
- Jadhavbhai Nathamal Singhvi Glaucoma Department, Medical Research Foundation, Sankara Nethralaya, Chennai, India
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9
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Yu L, Eaton AF, Yue Q, Bao HF, Ma HP, Cuppoletti J, Eaton DC. Unoprostone activation of BK (KCa1.1) channel splice variants. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2015; 1848:2859-67. [PMID: 26277265 DOI: 10.1016/j.bbamem.2015.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 07/19/2015] [Accepted: 08/11/2015] [Indexed: 01/14/2023]
Abstract
This investigation was conducted to study the relationship between intracellular Ca(2+) and activation of large conductance Ca(2+)-activated K(+) (BK) currents by unoprostone, the first synthetic docosanoid. We used HEK293 cells stably transfected with two BK channel splice variants, one sensitive to unoprostone and the other insensitive. We examined the effects of unoprostone on channel activity in excised inside-out patches and cell-attached patches. The half-maximal stimulation of the sensitive BK channels by Ca(2+) was shifted from 3.4±0.017 nM to 0.81±.0058 nM in the presence of 10 nM unoprostone. There was no effect on insensitive channels even at unoprostone concentrations as high as 1000 nM. There was no effect of unoprostone on the voltage dependence of the BK channels. Changes in open probability and effects of Ca(2+) and unoprostone were best described by a synergistic binding model. These data would suggest that Ca(2+) and unoprostone were binding to sites close to one another on the channel protein and that unoprostone binding causes the affinity of the calcium binding site to increase. This idea is consistent with three dimensional models of the Ca(2+) binding site and a putative unoprostone binding domain. Our results have important implications for the clinical use of unoprostone to activate BK channels. Channel activation will be limited if intracellular Ca(2+) is not elevated.
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Affiliation(s)
- Ling Yu
- College of Resources and Environmental Sciences, Nanjing Agricultural University, Nanjing 210095, China
| | - Amity F Eaton
- Department of Physiology and the Center for Cell and Molecular Signaling, Emory University School of Medicine Atlanta, GA 30322, United States
| | - Qiang Yue
- Department of Physiology and the Center for Cell and Molecular Signaling, Emory University School of Medicine Atlanta, GA 30322, United States
| | - Hui-Fang Bao
- Department of Physiology and the Center for Cell and Molecular Signaling, Emory University School of Medicine Atlanta, GA 30322, United States
| | - He-Ping Ma
- Department of Physiology and the Center for Cell and Molecular Signaling, Emory University School of Medicine Atlanta, GA 30322, United States
| | - John Cuppoletti
- Department of Molecular and Cellular Physiology, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Douglas C Eaton
- Department of Physiology and the Center for Cell and Molecular Signaling, Emory University School of Medicine Atlanta, GA 30322, United States.
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Sherwin JC, Kokavec J, Thornton SN. Hydration, fluid regulation and the eye: in health and disease. Clin Exp Ophthalmol 2015; 43:749-64. [DOI: 10.1111/ceo.12546] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 04/30/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Justin C Sherwin
- Royal Victorian Eye and Ear Hospital; Melbourne Victoria Australia
- Lions Eye Institute; University of Western Australia; Centre for Ophthalmology and Visual Science; Perth Western Australia Australia
| | - Jan Kokavec
- South Australian Institute of Ophthalmology; Royal Adelaide Hospital; Adelaide South Australia Australia
| | - Simon N Thornton
- Université de Lorraine; Nancy France
- INSERM U1116; Vandoeuvre les Nancy France
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Tran T, Niyadurupola N, O'Connor J, Ang GS, Crowston J, Nguyen D. Rise of intraocular pressure in a caffeine testversusthe water drinking test in patients with glaucoma. Clin Exp Ophthalmol 2013; 42:427-32. [DOI: 10.1111/ceo.12259] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 10/05/2013] [Indexed: 01/03/2023]
Affiliation(s)
- Tuan Tran
- Centre for Eye Research Australia; Glaucoma Unit; Royal Victorian Eye and Ear Hospital; East Melbourne Victoria Australia
| | - Nuwan Niyadurupola
- Centre for Eye Research Australia; Glaucoma Unit; Royal Victorian Eye and Ear Hospital; East Melbourne Victoria Australia
| | - Jeremy O'Connor
- Centre for Eye Research Australia; Glaucoma Unit; Royal Victorian Eye and Ear Hospital; East Melbourne Victoria Australia
| | - Ghee Soon Ang
- Centre for Eye Research Australia; Glaucoma Unit; Royal Victorian Eye and Ear Hospital; East Melbourne Victoria Australia
| | - Jonathan Crowston
- Centre for Eye Research Australia; Glaucoma Unit; Royal Victorian Eye and Ear Hospital; East Melbourne Victoria Australia
| | - Dan Nguyen
- Centre for Eye Research Australia; Glaucoma Unit; Royal Victorian Eye and Ear Hospital; East Melbourne Victoria Australia
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Hatanaka M, Alencar LM, De Moraes CG, Susanna R. Reproducibility of intraocular pressure peak and fluctuation of the water-drinking test. Clin Exp Ophthalmol 2012; 41:355-9. [PMID: 23009734 DOI: 10.1111/j.1442-9071.2012.02882.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 08/17/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND The water-drinking test has been used as a stress test to evaluate the drainage system of the eye. However, in order to be clinically applicable,a test must provide reproducible results with consistent measurements. This study was performed to verify the reproducibility of intraocular pressure peaks and fluctuation detected during the water-drinking test in patients with ocular hypertension and open-angle glaucoma. DESIGN A prospective analysis of patients in a tertiary care unit for glaucoma treatment. PARTICIPANTS Twenty-four ocular hypertension and 64 open-angle glaucoma patients not under treatment. METHODS The water-drinking test was performed in 2 consecutive days by the same examiners in patients not under treatment. Reproducibility was assessed using the intraclass correlation coefficient. MAIN OUTCOME MEASURES Peak and fluctuation of intraocular pressure obtained with the water-drinking test were analysed for reproducibility. RESULTS Eighty-eight eyes from 24 ocular hypertension and 64 open-angle glaucoma patients not under treatment were evaluated. Test and retest intraocular pressure peak values were 28.38 ± 4.64 and 28.38 ± 4.56 mmHg, respectively (P = 1.00). Test and retest intraocular pressure fluctuation values were 5.75 ± 3.9 and 4.99 ± 2.7 mmHg, respectively (P = 0.06). Based on intraclass coefficient, reproducibility was excellent for peak intraocular pressure (intraclass correlation coefficient = 0.79) and fair for intraocular pressure fluctuation (intraclass correlation coefficient = 0.37). CONCLUSION Intraocular pressure peaks detected during the water-drinking test presented excellent reproducibility, whereas the reproducibility of fluctuation was considered fair.
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Affiliation(s)
- Marcelo Hatanaka
- Glaucoma Service, University of São Paulo School of Medicine, São Paulo, Brazil.
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13
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Arora KS, Jefferys JL, Maul EA, Quigley HA. Choroidal thickness change after water drinking is greater in angle closure than in open angle eyes. Invest Ophthalmol Vis Sci 2012; 53:6393-402. [PMID: 22918644 DOI: 10.1167/iovs.12-10224] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To study change in choroidal thickness (CT) after water drinking test (WDT), comparing angle closure (AC) to open angle (OA) eyes. METHODS Before and 30 minutes after drinking 1 L of water, 88 glaucoma subjects underwent measurements of CT by spectral domain-optical coherence tomography, IOP, blood pressure (BP), axial length (AL), and anterior chamber depth (ACD). RESULTS Baseline CT was significantly greater in AC than in OA eyes (P = 0.002). After WDT, BP, IOP, and AL increased significantly (all P ≤ 0.0001). Mean CT increased significantly in the AC group (5.6 μm, P = 0.04, n = 40) and among 80 subjects whose IOP rose > 2 mm Hg (responders; 3.2 μm, P = 0.048), but not in the OA group or among all subjects (2.5 μm increase overall, <1% of baseline CT, P = 0.10). ACD decreased in AC (-18 μm, P = 0.07), but not in OA eyes (+3 μm, P = 0.74). AC eyes had a significantly greater IOP increase after WDT than OA eyes (P = 0.002, multivariate regression). Among responders, CT increased more in those with larger diastolic perfusion pressure increase and in AC compared to OA eyes (P = 0.04 and P = 0.053, respectively, multivariate regression). CONCLUSIONS A significant increase in CT and a decrease in ACD after WDT were observed in AC but not in OA eyes, and IOP increased significantly more in AC than in OA eyes, suggesting that the dynamic behavior of the choroid may play a role in the AC process. IOP increase after the WDT was not fully explained by CT increase.
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Affiliation(s)
- Karun S Arora
- Glaucoma Center of Excellence, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
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14
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Jinapriya D, Anraku A, Alasbali T, Trope GE, Buys YM. Evaluation of investigator bias in industry-funded clinical trials of latanoprost. Can J Ophthalmol 2012; 46:531-6. [PMID: 22153642 DOI: 10.1016/j.jcjo.2011.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2010] [Revised: 07/08/2011] [Accepted: 09/08/2011] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To determine whether sponsorship of prostaglandin analogue (PGA) clinical trials results in investigator bias in outcomes when studying intraocular pressure (IOP). DESIGN Retrospective, observational cohort study. METHODS A PubMed search was performed for latanoprost or Xalatan, bimatoprost or Lumigan, and travoprost or Travatan, with limits to humans, clinical trials, and English language. Inclusion criteria included randomized controlled trials, open-angle glaucoma, monotherapy with a PGA, baseline IOP ≥ 21 mm Hg, washout period, and minimum 1-month follow-up. Each article was reviewed by 2 independent reviewers. The results of IOP for each PGA were categorized as being sponsored by the parent company (the company manufacturing the PGA); by the competing company (the company manufacturing competing glaucoma therapy); or by a nonindustry source. The mean IOP and changes in IOP from baseline were compared among the 3 categories of sponsorship. RESULTS Only studies involving latanoprost were analyzed because of the low number of studies meeting the inclusion criteria for bimatoprost and travoprost. We found 29 and 13 studies that provided 1- and 3-month data, respectively, for analysis. The mean baseline IOPs in the 3 groups (parent company, competing company, nonindustry) were not significantly different (p = 0.47). The mean IOP at 1 (p = 0.72) and 3 months (p = 0.59) and the change in IOP from baseline (p = 0.83 and 0.90, respectively) were not significantly different in the 3 groups. A random-effects metaregression controlling for the covariates of blinding, naïveté to PGAs, and baseline IOP < 24 mm Hg or ≥ 24 mm Hg did not change the findings. CONCLUSION There was no evidence of investigator bias in determining outcomes for IOP in these clinical trials of latanoprost.
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Affiliation(s)
- Delan Jinapriya
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario
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15
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De Moraes CGV, Furlanetto RL, Reis ASC, Vegini F, Cavalcanti NF, Susanna R. Agreement between stress intraocular pressure and long-term intraocular pressure measurements in primary open angle glaucoma. Clin Exp Ophthalmol 2009; 37:270-4. [PMID: 19472536 DOI: 10.1111/j.1442-9071.2009.02003.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE The aim of this paper is to study the correlation between the intraocular pressure peaks and fluctuation detected during the water drinking test and the same parameters observed during long-term follow up. METHODS This prospective cohort study enrolled 22 eyes of 22 newly diagnosed primary open angle glaucoma patients. After an initial complete ophthalmological examination, patients were started on antiglaucoma medication and returned 4 weeks later to perform the water drinking test. Thereafter,patients were evaluated at least eight times within a period of 6-12 months. The intraocular pressure peaks and fluctuation detected during the water drinking stress test were compared with those observed during regular office visits. Spearman's correlation coefficient and Bland-Altman Plots were used for statistical analysis. RESULTS The mean age of participants was 54.3 +/- 8.2 years (+/-SD), 59% were women, and average mean deviation -10.2 +/- 4.5 dB. The mean follow-up period was 8.2 +/- 2.0 months. The average intraocular pressure peaks and fluctuation during the water drinking test were 20.0 +/- 2.9 mmHg and 40 +/- 10%, respectively, and 18.1 +/- 2.8 mmHg and 30 +/- 10% during follow up. Spearman's correlation coefficients were significant and strong between the intraocular pressure peaks and fluctuation detected during the water drinking test and during the follow-up period (P < 0.001, rho = 0.76 and 0.82,respectively). There was good agreement between the variables. CONCLUSION The intraocular pressure peaks and fluctuation detected during the water drinking test showed significant correlation and agreement with the pressures observed during follow-up visits. Stress tests could be used to estimate long-term intraocular pressure variation.
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Affiliation(s)
- Carlos Gustavo V De Moraes
- Glaucoma Service, Department of Ophthalmology, University of Sao Paulo School of Medicine, Sao Paulo, SP, Brazil.
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An eight-week, multicentric, randomized, interventional, open-label, phase 4, parallel comparison of the efficacy and tolerability of the fixed combination of timolol maleate 0.5%/brimonidine tartrate 0.2% versus fixed combination of timolol maleate 0.5%/dorzolamide 2% in patients with elevated intraocular pressure. J Glaucoma 2009; 17:674-9. [PMID: 19092465 DOI: 10.1097/ijg.0b013e318168f008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the efficacy and tolerability of the fixed combination of timolol maleate 0.5%/brimonidine tartrate 0.2% versus fixed combination of timolol maleate 0.5%/dorzolamide 2% in patients with elevated intraocular pressure (IOP) over 8 weeks. PATIENTS AND METHODS This 8-week, multicentric, interventional, randomized, open-label, parallel group study was conducted at 4 centers in Brazil and 1 center in Argentina. Patients with open-angle glaucoma or ocular hypertension were randomized to receive bilaterally fixed combination of brimonidine/timolol maleate 0.5% or fixed combination of dorzolamide 2%/timolol 0.5% twice daily at 8:00 AM and 8:00 PM. A modified diurnal tension curve (8:00 AM, 10:30 AM, 02:00 PM, and 4:00 PM) followed by the water drinking test (WDT), which estimates IOP peak of diurnal tension curve, were performed in the baseline and week-8 visits. Adverse events data were recorded at each visit. RESULTS A total of 210 patients were randomized (brimonidine/timolol, n=111; dorzolamide/timolol, n=99). Mean baseline IOP was 23.43+/-3.22 mm Hg and 23.43+/-4.06 mm Hg in the patients treated with brimonidine/timolol and dorzolamide/timolol, respectively (P=0.993). Mean diurnal IOP reduction after 8 weeks were 7.02+/-3.06 mm Hg and 6.91+/-3.67 mm Hg, respectively (P=0.811). The adjusted difference between groups (analysis of covariance) at week 8 was not statistically significant (P=0.847). Mean baseline WDT peak was 27.79+/-4.29 mm Hg in the brimonidine/timolol group and 27.68+/-5.46 mm Hg in the dorzolamide/timolol group. After 8 weeks of treatment, mean WDT peaks were 20.94+/-3.76 mm Hg (P<0.001) and 20.98+/-4.19 (P<0.001), respectively. The adjusted difference between groups (analysis of covariance) was not statistically significant (P=0.469). No statistical difference in terms of adverse events was found between groups. CONCLUSIONS Both fixed combinations were capable of significantly reducing the mean diurnal IOP, mean diurnal peak, and mean WDT peak after 8 weeks of treatment. Also, both fixed combinations are well tolerated with few side effects.
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Medeiros FA, Susanna R. Bimatoprost. Ophthalmology 2005; 112:1478; author reply 1479. [PMID: 16061098 DOI: 10.1016/j.ophtha.2004.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2004] [Indexed: 10/25/2022] Open
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