Therapeutic options in the treatment of open angle glaucoma and their use in accordance with the latest guidelines Review article
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Published:
Mar 31, 2024
Keywords:
glaucoma, pharmacological therapy, glaucoma drugs, combined drugs
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Abstract
Glaucoma is an optic neuropathy characterized by typical damage of the optic nerve with gradual atrophy of retinal ganglion cells and visual field defects. The goal of glaucoma therapy is to reduce intraocular pressure and reduce daily pressure fluctuations. Currently, in the treatment of primary open-angle glaucoma in Poland, we use four groups of drugs: β-adrenergic receptor antagonists, prostaglandin analogues, α-adrenergic receptor agonists and carbonic anhydrase inhibitors. First-line drugs, according to the guidelines of the Polish Ophthalmological Society, are prostaglandin analogues/prostamide. When considering the addition of a second drug to prostaglandins, brimonidine lowers intraocular pressure more strongly than dorzolamide or brinzolamide, similarly as timolol does. Drug containing two active substances are as effective as substances administered in two separate drops, therefore it is advantageous to use combined drug instead of using two different drugs.
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1.
Misiuk-Hojło M, Tomczyk-Socha M. Therapeutic options in the treatment of open angle glaucoma and their use in accordance with the latest guidelines. Ophthatherapy [Internet]. 2024Mar.31 [cited 2024May4];00. Available from: https://www.journalsmededu.pl/index.php/ophthatherapy/article/view/3058
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Conservative treatment
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Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
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10. Toumanidou V, Diafas A, Georgiadis N et al. Fixed versus Unfixed Combination of Topical Latanoprost/Timolol for Glaucoma: An Observational Study Investigating the Level of Adherence and Ocular Surface Health. J Clin Med. 2023; 12(9): 3137. http://doi.org/10.3390/jcm12093137.
11. Barnebey HS, Orengo-Nania S, Flowers BE et al. The safety and efficacy of travoprost 0.004%/timolol 0.5% fixed combination ophthalmic solution. Am J Ophthalmol. 2005; 140(1): 1-7. http://doi.org/10.1016/j.ajo.2005.02.043.
12. Hommer A; Ganfort Investigators Group I. A double-masked, randomized, parallel comparison of a fixed combination of bimatoprost 0.03%/timolol 0.5% with non-fixed combination use in patients with glaucoma or ocular hypertension. Eur J Ophthalmol. 2007; 17(1): 53-62. http://doi.org/10.1177/112067210701700108.
13. Konstas AG, Katsanos A, Athanasopoulos GP et al. Preservative-free tafluprost/timolol fixed combination: comparative 24-h efficacy administered morning or evening in open-angle glaucoma patients. Expert Opin Pharmacother. 2018; 19(18): 1981-8. http://doi.org/10.1080/14656566.2018.1534958.
14. Sherwood MB, Craven ER, Chou C. Twice-daily 0.2% brimonidine-0.5% timolol fixed-combination therapy vs monotherapy with timolol or brimonidine in patients with glaucoma or ocular hypertension: a 12-month randomized trial. Arch Ophthalmol. 2006; 124(9): 1230-8. http://doi.org/10.1001/archopht.124.9.1230.
15. Frampton JE. Topical brimonidine 0.2%/timolol 0.5% ophthalmic solution: in glaucoma and ocular hypertension. Drugs Aging. 2006; 23(9): 753-61. http://doi.org/10.2165/00002512-200623090-00005.
16. Razeghinejad MR, Sawchyn AK, Katz LJ. Fixed combinations of dorzolamide-timolol and brimonidine-timolol in the management of glaucoma. Expert Opin Pharmacother. 2010; 11(6): 959-68. http://doi.org/10.1517/14656561003667540.
17. Nixon DR, Yan DB, Chartrand JP et al. Three-month, randomized, parallel-group comparison of brimonidine-timolol versus dorzolamide-timolol fixed-combination therapy. Curr Med Res Opin. 2009; 25(7): 1645-53. http://doi.org/10.1185/03007990902994041.
18. Sall KN, Greff LJ, Johnson-Pratt LR et al. Dorzolamide/timolol combination versus concomitant administration of brimonidine and timolol: six-month comparison of efficacy and tolerability. Ophthalmology. 2003; 110(3): 615-24. http://doi.org/10.1016/S0161-6420(02)01900-0.
19. Hatanaka M, Grigera DE, Barbosa WL et al. An eight-week, multicentric, randomized, interventional, open-label, phase 4, parallel comparison of the efficacy and tolerability of the fixed combination of timolol maleate 0.5%/brimonidine tartrate 0.2% versus fixed combination of timolol maleate 0.5%/dorzolamide 2% in patients with elevated intraocular pressure. J Glaucoma. 2008; 17(8): 674-9. http://doi.org/10.1097/IJG.0b013e318168f008.
20. Boyle JE, Ghosh K, Gieser DK et al. A randomized trial comparing the dorzolamide-timolol combination given twice daily to monotherapy with timolol and dorzolamide. Dorzolamide-Timolol Study Group. Ophthalmology. 1998; 105(10): 1945-51. http://doi.org/10.1016/s0161-6420(98)91046-6.
21. Strohmaier K, Snyder E, DuBiner H et al. The efficacy and safety of the dorzolamide-timolol combination versus the concomitant administration of its components. Dorzolamide-Timolol Study Group. Ophthalmology. 1998; 105(10): 1936-44. http://doi.org/10.1016/s0161-6420(98)91045-4.
22. Kaback M, Scoper SV, Arzeno G et al. Brinzolamide 1%/Timolol 0.5% Study Group. Intraocular pressure-lowering efficacy of brinzolamide 1%/timolol 0.5% fixed combination compared with brinzolamide 1% and timolol 0.5%. Ophthalmology. 2008; 115(10): 1728-34, 1734.e1-2. http://doi.org/10.1016/j.ophtha.2008.04.011.
23. Januleviciene I. Brinzolamide 1%/timolol 0.5%: safety and efficacy of a new fixed-combination IOP-lowering product for glaucoma. Curr Med Res Opin. 2010; 26(11): 2575-8. http://doi.org/10.1185/03007995.2010.517718.
2. Szumny D, Misiuk-Hojło M. Leki stosowane w leczeniu jaskry. In: Prost M, Jachowicz R, Nowak J (ed). Kliniczna farmakologia okulistyczna. Elsevier, Wrocław 2013: 190-207.
3. Farmakoterapia jaskry. In: Rękas M (ed). Jaskra. Seria Basic and Clinical Science Course. 2nd ed. Edra Urban & Partner, Wrocław 2018: 181-204.
4. Polskie Towarzystwo Okulistyczne. Wytyczne diagnostyki i leczenia jaskry (aktualizacja 2022).
5. Stewart WC, Konstas AG, Nelson LA et al. Meta-analysis of 24-hour intraocular pressure studies evaluating the efficacy of glaucoma medicines. Ophthalmology. 2008; 115(7): 1117-22.e1. http://doi.org/10.1016/j.ophtha.2007.10.004.
6. Leske MC, Heijl A, Hyman L et al. Early Manifest Glaucoma Trial: design and baseline data. Ophthalmology. 1999; 106(11): 2144-53. http://doi.org/10.1016/s0161-6420(99)90497-9.
7. Bournias TE, Lai J. Brimonidine tartrate 0.15%, dorzolamide hydrochloride 2%, and brinzolamide 1% compared as adjunctive therapy to prostaglandin analogs. Ophthalmology. 2009; 116(9): 1719-24. http://doi.org/10.1016/j.ophtha.2009.03.050.
8. Pfeiffer N; European Latanoprost Fixed Combination Study Group. A comparison of the fixed combination of latanoprost and timolol with its individual components. Graefes Arch Clin Exp Ophthalmol. 2002; 240(11): 893-9. http://doi.org/10.1007/s00417-002-0553-0.
9. Higginbotham EJ, Feldman R, Stiles M et al.; Fixed Combination Investigative Group. Latanoprost and timolol combination therapy vs monotherapy: one-year randomized trial. Arch Ophthalmol. 2002; 120(7): 915-22. http://doi.org/10.1001/archopht.120.7.915.
10. Toumanidou V, Diafas A, Georgiadis N et al. Fixed versus Unfixed Combination of Topical Latanoprost/Timolol for Glaucoma: An Observational Study Investigating the Level of Adherence and Ocular Surface Health. J Clin Med. 2023; 12(9): 3137. http://doi.org/10.3390/jcm12093137.
11. Barnebey HS, Orengo-Nania S, Flowers BE et al. The safety and efficacy of travoprost 0.004%/timolol 0.5% fixed combination ophthalmic solution. Am J Ophthalmol. 2005; 140(1): 1-7. http://doi.org/10.1016/j.ajo.2005.02.043.
12. Hommer A; Ganfort Investigators Group I. A double-masked, randomized, parallel comparison of a fixed combination of bimatoprost 0.03%/timolol 0.5% with non-fixed combination use in patients with glaucoma or ocular hypertension. Eur J Ophthalmol. 2007; 17(1): 53-62. http://doi.org/10.1177/112067210701700108.
13. Konstas AG, Katsanos A, Athanasopoulos GP et al. Preservative-free tafluprost/timolol fixed combination: comparative 24-h efficacy administered morning or evening in open-angle glaucoma patients. Expert Opin Pharmacother. 2018; 19(18): 1981-8. http://doi.org/10.1080/14656566.2018.1534958.
14. Sherwood MB, Craven ER, Chou C. Twice-daily 0.2% brimonidine-0.5% timolol fixed-combination therapy vs monotherapy with timolol or brimonidine in patients with glaucoma or ocular hypertension: a 12-month randomized trial. Arch Ophthalmol. 2006; 124(9): 1230-8. http://doi.org/10.1001/archopht.124.9.1230.
15. Frampton JE. Topical brimonidine 0.2%/timolol 0.5% ophthalmic solution: in glaucoma and ocular hypertension. Drugs Aging. 2006; 23(9): 753-61. http://doi.org/10.2165/00002512-200623090-00005.
16. Razeghinejad MR, Sawchyn AK, Katz LJ. Fixed combinations of dorzolamide-timolol and brimonidine-timolol in the management of glaucoma. Expert Opin Pharmacother. 2010; 11(6): 959-68. http://doi.org/10.1517/14656561003667540.
17. Nixon DR, Yan DB, Chartrand JP et al. Three-month, randomized, parallel-group comparison of brimonidine-timolol versus dorzolamide-timolol fixed-combination therapy. Curr Med Res Opin. 2009; 25(7): 1645-53. http://doi.org/10.1185/03007990902994041.
18. Sall KN, Greff LJ, Johnson-Pratt LR et al. Dorzolamide/timolol combination versus concomitant administration of brimonidine and timolol: six-month comparison of efficacy and tolerability. Ophthalmology. 2003; 110(3): 615-24. http://doi.org/10.1016/S0161-6420(02)01900-0.
19. Hatanaka M, Grigera DE, Barbosa WL et al. An eight-week, multicentric, randomized, interventional, open-label, phase 4, parallel comparison of the efficacy and tolerability of the fixed combination of timolol maleate 0.5%/brimonidine tartrate 0.2% versus fixed combination of timolol maleate 0.5%/dorzolamide 2% in patients with elevated intraocular pressure. J Glaucoma. 2008; 17(8): 674-9. http://doi.org/10.1097/IJG.0b013e318168f008.
20. Boyle JE, Ghosh K, Gieser DK et al. A randomized trial comparing the dorzolamide-timolol combination given twice daily to monotherapy with timolol and dorzolamide. Dorzolamide-Timolol Study Group. Ophthalmology. 1998; 105(10): 1945-51. http://doi.org/10.1016/s0161-6420(98)91046-6.
21. Strohmaier K, Snyder E, DuBiner H et al. The efficacy and safety of the dorzolamide-timolol combination versus the concomitant administration of its components. Dorzolamide-Timolol Study Group. Ophthalmology. 1998; 105(10): 1936-44. http://doi.org/10.1016/s0161-6420(98)91045-4.
22. Kaback M, Scoper SV, Arzeno G et al. Brinzolamide 1%/Timolol 0.5% Study Group. Intraocular pressure-lowering efficacy of brinzolamide 1%/timolol 0.5% fixed combination compared with brinzolamide 1% and timolol 0.5%. Ophthalmology. 2008; 115(10): 1728-34, 1734.e1-2. http://doi.org/10.1016/j.ophtha.2008.04.011.
23. Januleviciene I. Brinzolamide 1%/timolol 0.5%: safety and efficacy of a new fixed-combination IOP-lowering product for glaucoma. Curr Med Res Opin. 2010; 26(11): 2575-8. http://doi.org/10.1185/03007995.2010.517718.