The Glaucoma Italian Pediatric Study (GIPSy): 3-Year Results.

Abstract

PURPOSE:

To investigate the efficacy and safety of a treatment strategy with latanoprost and dorzolamide in primary pediatric glaucoma patients partially responsive to surgery.

PATIENTS AND METHODS:

Children with primary pediatric glaucoma with postsurgical intraocular pressure (IOP) between 22 and 26 mm Hg were eligible. At baseline, patients were administered latanoprost once daily. Depending on IOP reduction, patients were allocated to continuation of latanoprost monotherapy or addition of dorzolamide twice daily, or switch to dorzolamide monotherapy 3 times daily. Patients in the dorzolamide monotherapy group with IOP reduction <20% from baseline were considered nonresponders. The primary endpoint was the percentage of responders. Study treatment continued for 3 years or until treatment failure.

RESULTS:

A total of 37 patients (61 eyes) were analyzed. The mean age of the patients was 4.1 years (SD: 3.8). In total, 43 eyes were included in the efficacy analysis. A total of 33 eyes (76.7%; 95% confidence interval, 61.4-88.2) were considered responders: 19 on latanoprost monotherapy, 11 on the latanoprost/dorzolamide combination, and only 3 on the dorzolamide monotherapy. The efficacy of pharmacological treatment was inversely related to central corneal thickness at the time of surgery and the age at the time of surgery. IOP reduction was 9.7 mm Hg (SD: 2.6) for latanoprost, 8.4 mm Hg (SD: 1.5) for the latanoprost/dorzolamide combination, and 9.3 mm Hg (SD: 2.5) for the dorzolamide monotherapy. None of the patients was withdrawn because of adverse events.

CONCLUSIONS:

Latanoprost alone or in combination with dorzolamide is safe and highly effective in lowering IOP in children after surgery. Nonresponders were mainly patients with early presentation of the disease.

• Authors: Luciano Quaranta, Elena Biagioli, Ivano Riva, Francesca Galli, Davide Poli, Eliana Rulli, Andreas Katsanos, Antonio Longo, Maurizio G Uva, Francesco Oddone, Valter Torri, Robert N Weinreb
• Journal: Journal of glaucoma (J Glaucoma) Vol. 27 Issue 10 Pg. 856-863 (10 2018) ISSN: 1536-481X [Electronic] United States
• PMID: 30095601 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antihypertensive Agents
• Sulfonamides
• Thiophenes
• Latanoprost
• dorzolamide

Topics

• Antihypertensive Agents (adverse effects, therapeutic use)
• Child
• Child, Preschool
• Drug Therapy, Combination
• Female
• Glaucoma (drug therapy, physiopathology)
• Humans
• Infant
• Intraocular Pressure (drug effects)
• Italy
• Latanoprost (adverse effects, therapeutic use)
• Male
• Ocular Hypertension (drug therapy)
• Prospective Studies
• Sulfonamides (adverse effects, therapeutic use)
• Thiophenes (adverse effects, therapeutic use)
• Tonometry, Ocular
• Treatment Outcome