24-hour Intraocular Pressure and Ocular Perfusion Pressure in Glaucoma

Quaranta, Luciano; Katsanos, Andreas; Russo, Andrea; Riva, Ivano

doi:10.1016/j.survophthal.2012.05.003

Cited by 140 publications

(160 citation statements)

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“…4,17 Importantly, 24-hour studies have confirmed that 24-hour IOP monitoring can significantly modify individualized glaucoma care in many glaucoma patients. 18,19 A few 24-hour studies have investigated travoprost efficacy over a period of up to 4 months, [11][12][13]20 but to date no evidence is available for the long-term 24-hour efficacy of travoprost monotherapy in glaucoma.…”

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confidence: 99%

“…Prostaglandin analogues have become a popular firstline therapy option for lowering IOP in POAG owing to their superior 24-hour efficacy, [1][2][3][4][5][6] convenient once-a-day administration, 5 and favorable systemic safety profile. 7 Travoprost is a synthetic prostaglandin F2a analogue that exerts its IOP-lowering effect through the prostaglandin FP receptors situated at the ciliary muscle 8 and the trabecular meshwork.…”

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confidence: 99%

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Long-term 24-hour Intraocular Pressure Control With Travoprost Monotherapy in Patients With Primary Open-angle Glaucoma

Riva

Katsanos

Floriani

et al. 2014

Journal of Glaucoma

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Purpose: The aim of the study was to evaluate the long-term 24-hour intraocular pressure (IOP) efficacy of travoprost monotherapy in primary open-angle glaucoma patients.Patients and Methods: A total of 36 previously untreated primary open-angle glaucoma patients were enrolled in this 5-year study.Patients underwent an untreated 24-hour IOP evaluation. Subsequently all patients were assigned to topical therapy with travoprost 0.004% eye-drops preserved with benzalkonium chloride (Travatan, Alcon Laboratories Inc., Fort Worth, TX) administered once in the evening (8:00 PM) in both eyes. All patients were then scheduled for a 24-hour IOP assessment approximately 12 months after the baseline visit. This schedule of follow-up was maintained for the whole duration of the trial. The predetermined range of target IOP reduction selected in this cohort of patients ranged between 20% and 30%.Results: A total of 34 patients completed all phases of the investigation. The mean survival time was 57.3 ± 2.0 months and the cumulative survival rate was 0.82 ± 0.6 at 60 months. Travoprost reduced the mean 24-hour IOP from 23.4 ± 1.7 mm Hg at baseline to 16.8 ± 2.4 mm Hg (28.4%), 16.8 ± 2.5 mm Hg (28.1%), 16.8 ± 2.4 mm Hg (28.5%), 16.7 ± 2.5 mm Hg (28.6%), and 16.9 ± 2.4 mm Hg (27.8%), respectively at the end of the first, second, third, fourth, and fifth year follow-up. No drug-related serious adverse events were registered during the study.Conclusions: The present study demonstrated the long-term 24-hour efficacy of travoprost for the treatment of primary open-angle glaucoma.Key Words: open-angle glaucoma, prostaglandin analogue, circadian intraocular pressure, travoprost (J Glaucoma 2014;23:535-540) R eduction of intraocular pressure (IOP) is the only currently available, evidence-based management strategy in patients affected with primary open-angle glaucoma (POAG). Most POAG patients will require lifelong medical therapy to avoid visual loss. The decision to select medical therapy options relies primarily on the efficacy of the available medications in various therapeutic trials. Sadly, most published studies only evaluate the short-term, daytime efficacy of medical therapy.Prostaglandin analogues have become a popular firstline therapy option for lowering IOP in POAG owing to their superior 24-hour efficacy, 1-6 convenient once-a-day administration, 5 and favorable systemic safety profile. 7 Travoprost is a synthetic prostaglandin F2a analogue that exerts its IOP-lowering effect through the prostaglandin FP receptors situated at the ciliary muscle 8 and the trabecular meshwork. 9 Travoprost is increasingly becoming a popular first-line monotherapy option for POAG patients 10 as there is cumulative evidence suggesting good quality of shortterm 24-hour IOP control with low fluctuation, especially with evening administration. 11-13 However, although several controlled studies have demonstrated the daytime short-term efficacy of travoprost monotherapy, [14][15][16] little is currently known about its long-term efficacy.As POA...

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Long-term 24-hour Intraocular Pressure Control With Travoprost Monotherapy in Patients With Primary Open-angle Glaucoma

Riva

Katsanos

Floriani

et al. 2014

Journal of Glaucoma

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“…11 Yet, we still know little about the physiology of SC in normal people. As there is IOP fluctuation throughout the whole day, [12][13][14] it is not known if there will be ''morphological fluctuation'' of the SC. Moreover, are there other factors, such as autonomic nervous activity, influencing the morphology of SC in addition to IOP?…”

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Diurnal Variations in the Morphology of Schlemm's Canal and Intraocular Pressure in Healthy Chinese: An SS-OCT Study

Gao

Aung

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.To characterize the diurnal variations in the dimensions of the Schlemm's canal (SC) and its association with intraocular pressure (IOP) using swept-source optical coherence tomography (SS-OCT).METHODS. The temporal, nasal, inferior, and superior limbus of 102 eyes of 51 healthy subjects were imaged in vivo by SS-COT at 5 time points of 8 AM, 11 AM, 2 PM, 5 PM, and 8 PM. IOP was measured at the same time by Goldmann applanation tonometry (GAT). The diameter and the cross-sectional area of the SC were measured in ImageJ. The associations between changes in the SC parameters, IOP, and other biometric parameters were determined using a general estimating equations model. The temporal and inferior limbus of 94 eyes of 47 healthy subjects were also imaged before and during the Valsalva maneuver (VM) at 8 PM. RESULTS.Mean IOPs at different time points were 13.37, 12.89, 11.9, 12.02, and 12.36 mm Hg. Of all four quadrants, the detectable rate of SC was highest in the superior quadrant (85.3%) and lowest in the inferior quadrant (75.5%). We found that changes in the SC area and diameter were negatively associated with IOP changes only in the inferior quadrant (P ¼ 0.0046 and P ¼ 0.0332, respectively), after adjusting for age, sex, eye, spherical equivalent, and axial length. The mean SC area and diameter during the VM were significantly higher than prior to the VM (P < 0.001).CONCLUSIONS. The changes in the SC parameters were negatively associated with IOP changes only in the inferior quadrant. The VM could expand the SC in healthy subjects. Imaging of the SC may be a useful method to discover the reason why IOP fluctuates, and how SC changes morphologically during the daytime in the future.Keywords: Schlemm's canal, intraocular pressure, Valsalva maneuver T he rate of ocular aqueous humor (AH) drainage can affect intraocular pressure (IOP).1 In normal people, the aqueous humor is mainly drained through trabecular meshwork into the Schlemm's canal (SC), and then it flows into collector canals and episcleral veins. Aging, inflammation, and other immune factors could change the structural component in the outflow pathway of the AH, leading to imbalance in AH dynamics. [2][3][4] Blockage in any of the structures above will lead to the obstruction of AH drainage, causing ocular hypertension. 5Elevated IOP is an important risk factor for glaucoma and optic nerve damage. 6 Before the 21st century, the observation of SC in vivo was limited by imaging techniques. With the invention of highresolution optical coherence tomography (OCT), SC imaging in vivo became possible. Previous studies using OCT demonstrated that the SC area in patients with primary open angle glaucoma (POAG) and pseudoexfoliation glaucoma was decreased compared to normal people. [7][8][9] In addition, the morphology of SC can be affected by the application of prostaglandins and surgery. A study by Chen et al. 10 showed that the SC area expanded following the use of travoprost in healthy subjects. Similarly, expansion of SC was also detected after trab...

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“…Does the new drug affect non-IOP parameters (e.g. ocular hemodynamics) that can have an impact on glaucoma [15]? And ultimately, how good is each agent at preserving vision over the long term?…”

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confidence: 99%