Intraocular pressure-lowering effects of commonly used fixed combination drugs with timolol in the management of primary open angle glaucoma

Therapeutic Effects of Hab Shabyar on Open-Angle Glaucoma: A Double-Blinded, Randomized, Placebo-Controlled Trial

Background:

Open-angle glaucoma (OAG) is one of the leading causes of blindness worldwide. This study evaluates the therapeutic effects of hab shabyar in patients with open-angle glaucoma.

Materials and Methods:

In this clinical randomized controlled trial, 50 patients with OAG were randomized into two groups. The intervention group received a drop of timolol plus 500 mg of hab shabyar every 12 hours. The placebo group received a drop of timolol every 12 hours plus 500 mg of wheat germ as a placebo. The intraocular pressure in patients with OAG was measured in each group and compared before the intervention (t1), one month (t2), and two months (t3) after the intervention.

Results:

The mean decrease in intraocular pressure for the right eye on three times in the intervention group was statistically significant, but the mean decrease in the placebo group was not significant. Similar results were obtained for the left eye at t1 when compared to t3. The intervention group patients expressed more satisfaction changes than the placebo group (P≤0.001).

Conclusion:

Our study demonstrated that consumption of timolol plus hab shabyar instead of consuming timolol alone was probably more effective for reducing intraocular pressure in patients with OAG.

Selective Laser Trabeculoplasty vs. Fixed Combinations with Timolol in Practice: A Replacement Study in Primary Open Angle Glaucoma

OBJECTIVES

To evaluate the potential of selective laser trabeculoplasty (SLT) in two arms (360˚ vs. 180˚) as a replacement for fixed combinations (FCs) with timolol in primary open angle glaucoma over 6 months.

MATERIALS AND METHODS

Of 40 patients in a prospective, comparative, interventional case series, 18 eyes and 22 eyes were randomized to SLT 180º and SLT 360º groups, respectively, along with 40 fellow-control eyes. FC with timolol was discontinued on the day of treatment for the eye to be operated on, while ongoing therapy was not interrupted for the contralateral eye. Eyes were examined for intraocular pressure (IOP) elevation 1 hour and 1 day after SLT. The follow-up visits were then scheduled for 1 week, 1 month, 3 months, and 6 months after, during the which the IOP of both eyes and any possible complications were evaluated.

RESULTS

There were no statistically significant differences in mean IOPs through 6 months among the groups with exception of postlaser 1 hour and postlaser 1 day (p<0.001 and p=0.010, respectively). Multiple comparison analysis showed significantly higher IOP in both SLT 180º and SLT 360º subgroups compared to their controls at postlaser 1 hour (p=0.007, p<0.001) but significantly lower IOP only in SLT 360º subgroup compared to the controls at postlaser day 1 (p=0.013).

CONCLUSION

SLT offers promising potential as a substitute equivalent to efficacy of FCs with timolol. However, SLT 360˚ may not achieve additional IOP reduction.

Automatic method of analysis and measurement of additional parameters of corneal deformation in the Corvis tonometer

INTRODUCTION

The method for measuring intraocular pressure using the Corvis tonometer provides a sequence of images of corneal deformation. Deformations of the cornea are recorded using the ultra-high-speed Scheimpflug camera. This paper presents a new and reproducible method of analysis of corneal deformation images that allows for automatic measurements of new features, namely new three parameters unavailable in the original software.

MATERIAL AND METHOD

The images subjected to processing had a resolution of 200 × 576 × 140 pixels. They were acquired from the Corvis tonometer and simulation. In total 14,000 2D images were analysed. The image analysis method proposed by the author automatically detects the edge of the cornea and sclera fragments. For this purpose, new methods of image analysis and processing proposed by the author as well as those well-known, such as Canny filter, binarization, median filtering etc., have been used. The presented algorithms were implemented in Matlab (version 7.11.0.584-R2010b) with Image Processing toolbox (version 7.1-R2010b) using both known algorithms for image analysis and processing and those proposed by the author.

RESULTS

Owing to the proposed algorithm it is possible to determine three parameters: (1) the degree of the corneal reaction relative to the static position; (2) the corneal length changes; (3) the ratio of amplitude changes to the corneal deformation length. The corneal reaction is smaller by about 30.40% compared to its static position. The change in the corneal length during deformation is very small, approximately 1% of its original length. Parameter (3) enables to determine the applanation points with a correlation of 92% compared to the conventional method for calculating corneal flattening areas. The proposed algorithm provides reproducible results fully automatically within a few seconds/per patient using Core i7 processor.

CONCLUSIONS

Using the proposed algorithm, it is possible to measure new, additional parameters of corneal deformation, which are not available in the original software. The presented analysis method provides three new parameters of the corneal reaction. Detailed clinical studies based on this method will be presented in subsequent papers.