Effect of bimatoprost on patients with primary open-angle glaucoma or ocular hypertension who are nonresponders to latanoprost☆
Section snippets
Material and methods
We searched the records of the Glaucoma Clinic of our institute to identify patients with a history of lack of response to latanoprost (i.e., ≤10% IOP lowering after 6 to 8 weeks of treatment with latanoprost, 0.005% every day). Among those identified, 15 agreed to be treated with bimatoprost and rechallenged with latanoprost in a prospective, randomized, investigator-masked crossover study. The eligibility criteria are listed in Table 1. Demographics are detailed in Table 2.
The protocol was
Results
All subjects completed the study. No significant changes in visual acuity, visual field, and corneal pachymetry were detected throughout follow-up (data not shown).
IOP data (mean and standard deviation of all measurements throughout the day) were as follows: baseline = 24.7 (0.9) mmHg; 30 days washout = 24.8 (1.1) mmHg; 30 days latanoprost = 24.1 (0.9) mmHg; 30 days bimatoprost = 18.1 (1.7) mmHg. IOP after bimatoprost was significantly lower than both the baseline IOP (P < 0.0001, paired
Discussion
We were able to identify, among the population of patients referred to our Glaucoma Service, 15 nonresponders to latanoprost 0.005% 2D. The prevalence of nonresponders to latanoprost monotherapy in human glaucomas is presently unknown. Approximately 1% of subjects enrolled in 2 major clinical trials and treated with latanoprost, 0.005% 2D, monotherapy were withdrawn because of uncontrolled IOP.1, 4 A more than 20-fold higher prevalence of nonresponders has been reported when latanoprost was
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Manuscript no. 210929.
Supported by a local grant (FIL) from the University of Parma, Parma, Italy.
The authors have no financial and/or proprietary interest in any of the products or companies mentioned in the study.