Primary open angle glaucoma: an overview on medical therapy

Vetrugno, Michele; Cantatore, Francesco Paolo; Ruggeri, Giuseppe; Ferreri, Paolo; Montepara, Alfonso; Quinto, Alessandra; Sborgia, Carlo

doi:10.1016/s0079-6123(08)01113-8

Cited by 10 publications

(4 citation statements)

References 21 publications

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“…Anti-glaucoma ophthalmic solutions are required to possess the following characteristics: excellent potential for IOP reduction, good tolerance, and little adverse effects. PG analogues, in particular latanoprost, are considered to be a good candidate [5-7]. …”

Section: Discussionmentioning

confidence: 99%

Changes in Trend of Newly Prescribed Anti-Glaucoma Medications in Recent Nine Years in a Japanese Local Community

Kashiwagi¹

2010

TOOPHTJ

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Purpose:To investigate changes in the trend of anti-glaucoma ophthalmic solutions in 2000-2008 in a Japanese local community.Materials and Methods:The subjects of this study were patients with glaucoma who were registered in the database of the glaucoma clinic of University of Yamanashi Hospital or the database of the Association for Research in Supporting System of Chronic Diseases (ARSSCD). The trend of newly prescribed anti-glaucoma ophthalmic solutions from January 2000 through July 2008 was analyzed. Changes in the trend of anti-glaucoma ophthalmic solutions and the persistence of each anti-glaucoma ophthalmic solution were investigated.Results:A total of 1,955 glaucoma patients were enrolled. Mean intraocular pressure (IOP) significantly reduced by year (R2=0.7938, p<0.001). The number of new prescriptions for analysis in the study period was 7,831. Prostaglandin (PG) analogues accounted for approximately 40% of the prescriptions during the period, and were followed by beta-blockers and carbonic anhydrase inhibitors (CAIs). Those three anti-glaucoma ophthalmic solutions accounted for approximately 90% of all the prescriptions. Latanoprost showed the longest persistence among the anti-glaucoma ophthalmic solutions. The number of newly prescribed anti-glaucoma ophthalmic solutions gradually increased with time.Conclusions:PG analogues are the most frequently prescribed and latanoprost showed the longest persistence among the anti-glaucoma ophthalmic solutions. PG analogues, beta-blockers, and CAIs accounted for the majority of newly prescribed anti-glaucoma ophthalmic solutions. An increase in the number of newly prescribed anti-glaucoma ophthalmic solutions may contribute to further IOP reduction.

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Section: Discussionmentioning

confidence: 99%

Changes in Trend of Newly Prescribed Anti-Glaucoma Medications in Recent Nine Years in a Japanese Local Community

Kashiwagi¹

2010

TOOPHTJ

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“…[ 16 ] These two mechanisms may lead to ocular blood flow deficits that may result in optic nerve head vessel dysfunction or ischemic optic microinfarction, ultimately causing glaucomatous damage. [ 16,33,34 ]…”

Section: Fish Oil Regulates the Blood Supplymentioning

confidence: 99%

Fish Oil in Glaucoma Treatment: From Biological Functions to Clinical Potential

Liu

et al. 2023

Molecular Nutrition Food Res

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Glaucoma is the leading cause of irreversible vision loss worldwide, and multiple risk factors influence its pathogenesis and progression, including age, increased intraocular pressure (IOP), low-grade inflammation, oxidative stress, and ocular blood flow deficits. IOP-lowering therapy is currently the most effective way to control glaucoma progression; however, due to insufficient response and persistent retinal neural degeneration, the result may not always be satisfactory. In recent decades, fish oil, an omega-3 dietary supplement, is reported to be beneficial to glaucoma patients, but its efficiency and underlying mechanisms remain unclear. Intriguingly, glaucoma patients have lower omega-3 fatty acid blood levels, especially docosahexaenoic acid and eicosapentaenoic acid. Dietary omega-3 supplementation in patients may normalize levels of fatty acid and, thereby, enhance their effects. Therefore, fish oil may serve as an area of new focus for glaucoma treatment studies. In this review, the study summarizes the roles of active ingredients in fish oil in delaying glaucoma development, including lowering IOP, regulating blood supply, alleviating inflammation, and diminishing oxidative stress, with a view to promoting the development of the clinical management of glaucoma.

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“…With a monocular trial, the pressure is taken in each eye before starting the new medication (ie, 23 right eyes [OD], 25 left eyes [OS]), the drug is started in only one eye (OD, for example), and then the pressure is measured in each eye several weeks later. If the pressure in the treated eye decreases in relation to the pressure in the untreated eye and decreases >15% from the baseline pressure, the medication is deemed effective 19. There are several assumptions made with this technique 20.…”

Section: Introductionmentioning

confidence: 99%

Comparing the efficacy of the monocular trial treatment paradigm with multiple measurements of intraocular pressure before and after treatment initiation in primary open-angle glaucoma

Krishna¹,

Debry²,

Waldman³

et al. 2012

OPTH

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The monocular trial has been proposed as a test to help control for diurnal fluctuations in eye pressure when assessing medication effectiveness. We undertook a prospective study to determine the sensitivity and specificity of the monocular trial as a test for determining the effectiveness of a glaucoma medication. The efficacy of the monocular trial was compared to the diagnostic paradigm of repeated pre- and post-treatment measurements in determining whether an intraocular pressure (IOP)-lowering drug is effective. Forty-two patients with newly diagnosed open-angle glaucoma completed five visits: visit 1 for determining eligibility, obtaining consent, and measuring IOP, visit 2 for a second pressure measurement, and visit 3 for a third pressure reading. The new medication was then started in one eye. IOP measurements were made at weeks 4 and 6. The gold standard IOP change was defined as the difference in mean between the pre- and post-medication visits. A medication was deemed effective if this difference was at least 15%. The monocular trial pressure change was defined as the IOP change in the treated eye between the visit immediately before and immediately after the medication addition, corrected by subtracting the pressure change in the untreated eye. All 42 patients completed the full protocol with good compliance. Twenty-five of 42 (60%) medication additions were considered effective by the gold standard method, and 25/42 (60%) by the monocular trial method. However, the two methods agreed in only 26 patients (17 Yes/Yes, 9 No/No). The calculated sensitivity was low (0.68), with a specificity of 0.53. The monocular trial can give useful clues as to whether a medication is effective, but should not be the only information used in making this determination. To obtain the most valid results, multiple pressure checks should be done before and after starting a new medication.

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Primary open angle glaucoma: an overview on medical therapy

Cited by 10 publications

References 21 publications

Changes in Trend of Newly Prescribed Anti-Glaucoma Medications in Recent Nine Years in a Japanese Local Community

Changes in Trend of Newly Prescribed Anti-Glaucoma Medications in Recent Nine Years in a Japanese Local Community

Fish Oil in Glaucoma Treatment: From Biological Functions to Clinical Potential

Comparing the efficacy of the monocular trial treatment paradigm with multiple measurements of intraocular pressure before and after treatment initiation in primary open-angle glaucoma

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