A COMPARATIVE STUDY OF TWO FIXED DOSE COMBINATIONS IN PRIMARY OPEN ANGLE GLAUCOMA

Chawla S.*, Kaushal J. and Sachdeva S.

ABSTRACT

Objective: To study efficacy & safety of fixed dose combination of latanoprost/timolol versus brinzolamide/brimonidine in primary open angle glaucoma. Methods: A prospective, randomized, comparative, clinical study was conducted on 50 patients. The patients were randomly divided in two groups of 25 each to receive following two treatments: Group A (n=25) Latanoprost and Timolol (0.005+0.5%w/v) ophthalmic solution once daily; Group B (n=25) Brinzolamide and Brimonidine (1%+0.15%w/v) ophthalmic solution thrice daily for 12 weeks. Efficacy assessment was done at the end of 2, 4, 6 and 12 weeks by observing Intra Ocular Pressure (IOP) changes from baseline. At baseline & 12 weeks number of patients having IOP less than or equal to 18 mm Hg, visual field defect with automated perimetry & optic disc changes by dilated fundoscopy were seen. Overall improvement was observed from baseline with the clinical global impression improvement scale (CGI-I). Safety assessment of both the groups was also done. Results: At the end of 2,4,6 and 12 weeks, statistically highly significant reduction in mean IOP from baseline was observed in both the groups but reduction was more in group A as compared to group B (31.1% Vs 25.2%; p<0.001) at the end of 12 weeks. Number of patients having IOP less than or equal to 18 mm of Hg was also more in group A Vs group B (25% Vs 4%; p<0.05) at the end of 12 weeks. Visual field defect, optic- cup to disc ratio showing progression of disease was more in group B. CGI-I scale was statistically highly significant with group A better than Group B (70.37% Vs 45.25%). Safety profile was better in group A than group B. Conclusion: Latanoprost/Timolol was found to be more efficacious & safer than Brinzolamide/ Brimonidine combination in primary open angle glaucoma.

Keywords: Latanoprost, Timolol, Brinzolamide, Brimonidine, Intra Ocular Pressure, Visual field defect, optic- cup to disc ratio, Clinical global impression improvement.