Effects of Brimonidine and Timolol on the Progression of Visual Field Defects in Open-angle Glaucoma: A Single-center Randomized Trial.

Abstract

PRéCIS:: Instillation of brimonidine or timolol slowed visual field deterioration in patients with open-angle glaucoma; both brimonidine and timolol might improve the mean deviation (MD) slopes.

PURPOSE:

The purpose of this study was to investigate and compare the effects of 0.1% brimonidine and 0.5% timolol on the progressing visual field defects in open-angle glaucoma.

PATIENTS AND METHODS:

We evaluated 1 eye each of 68 glaucoma patients who were treated with at least 1 prostaglandin analog. Their baseline MD slopes were < -0.5 dB/y based on at least 5 Humphrey field analyzer measurements within 3 years. Eligible eyes were randomly assigned to brimonidine or timolol treatment groups and treatments were administered without the wash-out period. Clinical examinations were performed every 4 months for 2 years. We designated the MD slope as the primary endpoint.

RESULTS:

Ultimately, 56 eyes (brimonidine:timolol=26:30) were included in the present study (mean age=65.2 y). Dropout rates of brimonidine and timolol treatment groups were 27.8% and 6.3%, respectively. There were no significant differences in baseline intraocular pressure or MD slopes between brimonidine and timolol groups (12.7 and 12.9 mm Hg, P=0.77, and -1.22 and -1.08 dB/y, P=0.43, respectively). Intraocular pressure decreased significantly in the brimonidine group at 4, 8, 12, and 16 months, and in the timolol group at 4 months, without significant differences between the drugs (P=0.20). MD slopes significantly improved in both groups (brimonidine: -0.38 dB/y, P<0.001; timolol: -0.52 dB/y, P=0.04). Furthermore, there was no significant difference between groups in the primary endpoint (P=0.59).

CONCLUSION:

Brimonidine and timolol treatments improved MD slopes in open-angle glaucoma.

• Authors: Yu Yokoyama, Ryo Kawasaki, Hidetoshi Takahashi, Shigeto Maekawa, Satoru Tsuda, Kazuko Omodaka, Toru Nakazawa
• Journal: Journal of glaucoma (J Glaucoma) Vol. 28 Issue 7 Pg. 575-583 (07 2019) ISSN: 1536-481X [Electronic] United States
• PMID: 31188229 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Antihypertensive Agents
• Brimonidine Tartrate
• Timolol

Topics

• Aged
• Antihypertensive Agents (therapeutic use)
• Brimonidine Tartrate (therapeutic use)
• Disease Progression
• Double-Blind Method
• Female
• Glaucoma, Open-Angle (diagnosis, drug therapy, physiopathology)
• Humans
• Intraocular Pressure (drug effects)
• Male
• Middle Aged
• Prospective Studies
• Timolol (therapeutic use)
• Tonometry, Ocular
• Vision Disorders (diagnosis, drug therapy, physiopathology)
• Visual Field Tests
• Visual Fields (drug effects)