Ocular surface evaluation in patients treated with a fixed combination of prostaglandin analogues with 0.5% timolol maleate topical monotherapy: a randomized clinical trial

Ocular surface evaluation in patients treated with a fixed combination of prostaglandin analogues with 0.5% timolol maleate topical monotherapy: a randomized clinical trial

Author Russ, Heloisa Helena Autor UNIFESP Google Scholar
Nogueira Filho, Pedro Antonio Autor UNIFESP Google Scholar
Barros, Jeison de Nadai Autor UNIFESP Google Scholar
Faria, Nubia Vanessa Lima de Google Scholar
Montiani-Ferreira, Fabiano Google Scholar
Gomes, José Álvaro Pereira Autor UNIFESP Google Scholar
Mello, Paulo Augusto de Arruda Autor UNIFESP Google Scholar
Institution Graefe Institute of Ophthalmology Glaucoma Department
Universidade Federal de São Paulo (UNIFESP)
Brasilia Base Hospital Glaucoma Department
Federal University of Parana Veterinary Department
Abstract OBJECTIVES: To compare ocular surface changes induced via glaucoma treatment in patients using fixed combinations of prostaglandin analogues (travoprost, latanoprost and bimatoprost) with 0.5% timolol maleate METHODS: A prospective, multicenter, randomized, parallel group, single-blind clinical trial was performed in 33 patients with ocular hypertension or open angle glaucoma who had not been previously treated. The ocular surface was evaluated prior to and three months after treatment, with a daily drop instillation of one of the three medications. The main outcome measurements included the tear film break-up time, Schirmer's test, Lissamine green staining, the Ocular Surface Disease Index questionnaire, impression cytology using HE and PAS and immunocytochemistry for interleukin-6 and HLA-DR. Ensaiosclinicos.gov.br: UTN - U1111-1129-2872 RESULTS: All of the drugs induced a significant reduction in intraocular pressure. Decreases in the Schirmer's test results were observed with all of the drugs. Decreases in tear-film break-up time were noted with travoprost/timolol and latanoprost/timolol. An increase in the Lissamine green score was noted with travoprost/timolol and bimatoprost/timolol. The Ocular Surface Disease Index score increased after treatment in the travoprost/timolol group. Impression cytology revealed a significant difference in cell-to-cell contact in the same group, an increase in cellularity in all of the groups and an increase in the number of goblet cells in all of the groups. The fixed combinations induced an increase in IL-6 expression in the travoprost/timolol group, in which there was also an increase in HLA-DR expression. CONCLUSIONS: All of the fixed combinations induced a significant reduction in intraocular pressure, and the travoprost/timolol group showed increased expression of the inflammatory markers HLA-DR and interleukin-6. All three tested medications resulted in some degree of deterioration in the ocular surface after three months of glaucoma treatment.
Keywords Glaucoma
Language English
Sponsor Federal University of Sao Paulo
Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)
Date 2013-10-01
Published in Clinics. Faculdade de Medicina / USP, v. 68, n. 10, p. 1318-1324, 2013.
ISSN 1807-5932 (Sherpa/Romeo, impact factor)
1980-5322 (Sherpa/Romeo, impact factor)
Publisher Faculdade de Medicina / USP
Extent 1318-1324
Origin http://dx.doi.org/10.6061/clinics/2013(10)05
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000326988300005
SciELO ID S1807-59322013001001318 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/7993

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