Comparison of the efficacy and safety of timolol in combination with dorzolamide, brimonidine or latanoprost in patients of primary open angle glaucoma.

Abstract

The present study was undertaken to compare the efficacy and safety of timolol with dorzolamide, brimonidine or latanoprost in patients of primary open angle glaucoma. This prospective, observational study was conducted over one and a half year at the Regional Eye Institute, in patients of primary open angle glaucoma who were prescribed dorzolamide (2%) and timolol (0.5%) (DT), brimonidine (0.1%) and timolol (0.5%) (BT) or latanoprost (0.005%) and timolol (0.5%) (LT). Measurement of intraocular pressure (IOP) and indirect ophthalmoscopy was done at baseline and after 1, 3 and 6 months of treatment. Efficacy was assessed by the degree of reduction in intraocular pressure and change in cup-disc ratio. Adverse drug reactions (ADRs), if any, were recorded. The data was analysed using Student’s ‘t’ test and one-way ANOVA test. P value < 0.05 was considered to be statistically significant. Total number of 35 patients in DT group, 34 in BT group and 32 in LT group completed the study. At the end of 6 months, average reduction in IOP levels was 7.83, 9.39 and 9.73mmHg in DT, BT and LT groups respectively. Thus, a percent reduction of 29.4, 35.6 and 36.2 from baseline was observed in these groups respectively. While the reduction was maximum in LT group, there was no statistically significant difference between any of the groups at 1, 3 or 6 months. A total of 47 ADRs were reported, none of which required discontinuation. All three combinations are effective in reducing the IOP level in patients of primary open angle glaucoma and none appear to be superior to the others.