Longterm visual field follow-up of glaucoma patients treated with beta-blockers

Influence of Topical Betaxolol and Timolol on Visual Field in Japanese Open-angle Glaucoma Patients

“…The present result obtained for MD in patients receiving betaxolol or timolol is compatible with those reported by Drance 25 or Kaiser et al, 23 but different from those of Collignon-Brach 22 or Tasindi et al 24 who found significant improvement of MD in the betaxolol-treated group. Because MD is not useful in detecting local sensitivity changes, we clustered test points of the 30-2 program of the Humphrey Perimeter according to the study of Suzuki et al 35 into 15 clusters (sectors in the visual field), complying with INFLUENCE OF BETAXOLOL AND TIMOLOL ON VISUAL FIELD the anatomy of retinal nerve fiber bundles.…”

“…When normal-tension glaucoma patients with a mean untreated IOP of 16 mm Hg or higher were included, the baseline IOP averaged 18.5 mm Hg in the present subjects, while that in these previous studies averaged 23-24 mm Hg. [21][22][23][24][25] Thus, the contribution of IOP-independent damaging factors to the progression of visual field damage, if they exist, [8][9][10][11][12] was thought to be relatively more significant in these Japanese subjects than in the subjects in the previous studies. The possible therapeutic effects of betaxolol on IOP-independent damaging factors in open-angle glaucoma may be more sensitively detected in the present Japanese subjects.…”

“…Systemic calcium antagonists may be beneficial at least temporarily in slowing the progression of visual field damage in a subset of open-angle glaucoma patients. [13][14][15][16][17][18][19][20] Several studies using topical betaxolol and timolol suggested that there might be dissociation between ocular hypotensive effects and slowing of visual field damage, [21][22][23][24][25] ie, topical betaxolol might have marginally better effects on glaucomatous visual field damage despite having less effect on IOP reduction than topical timolol.…”

“…Thus, in Japanese glaucoma patients, management of IOP-independent damaging factors, if possible, may be of more clinical significance. The possibly beneficial effects of topical betaxolol, [21][22][23][24][25] which should be associated with less systemic effects than oral calcium antagonists, should be re-examined in this population. We carried out a multicenter, 2-year, prospective, randomized and double-masked study to estimate the effects of topical betaxolol and timolol on visual field performance and IOP in Japanese open-angle glaucoma patients, and we report the results in this communication.…”

Reducing intraocular pressure: is surgery better than drugs?

“…Betaxolol (Betoptic) is a cardioselective beta-blocker, but is associated with poorer IOP control. 99 Carbonic anhydrase inhibitors 31,48,[100][101][102][103][104][105][106] applied topically are associated with less serious systemic side effects, but are also less potent than if orally administered. Prostaglandins 19,41,48,96 are, however, very effective at lowering the IOP with, as far as we know, minimal systemic side effects, and have become the treatment of first choice in many cases.…”