Effect of timolol on the diurnal intraocular pressure in exfoliation and primary open-angle glaucoma.

Abstract

OBJECTIVE:

To describe and compare the diurnal intraocular pressure (IOP) variation in patients with exfoliation glaucoma (EXG) and primary open-angle glaucoma (POAG) who were treated with a solution of timolol maleate (0.5%) twice daily.

DESIGN:

Consecutive Greek patients who were newly diagnosed as having EXG or POAG were prospectively investigated; they underwent 24-hour diurnal IOP measurements first without therapy and then 6 months afterward while they were being treated with timolol maleate (0.5%). After matching for age, 38 pairs of patients with these 2 types of glaucoma were compared.

RESULTS:

Untreated patients with EXG had significantly higher IOP values for all time points assessed and a greater mean range of IOPs (11.8 mm Hg for EXG vs 7.6 mm Hg for POAG; P < or = .001). Following therapy with timolol maleate (0.5%) given twice daily, patients with EXG had higher IOP values for the measurements that were obtained at 6 and 10 AM, 10 PM, and 2 AM, a higher mean range of IOPs (7.0 mm Hg for EXG vs 5.6 mm Hg for POAG; P = .03), and a higher maximum IOP (mean, 24.9 mm Hg for EXG vs 20.9 mm Hg for POAG; P = .003). The reduction of the range of diurnal variation of IOP was more pronounced in patients with EXG than in patients with POAG (40% vs 26%; P = .04). Twenty-two (58%) of 38 patients with EXG and 20 (53%) of 38 patients with POAG had peak IOP values that were found outside office hours. Only 5 (13%) of the patients with EXG exhibited an IOP of 18 mm Hg or less at all time points compared with 12 (32%) of the patients with POAG (P = .05).

CONCLUSION:

Despite a greater initial IOP reduction in the patients with EXG treated with timolol, a higher IOP and significant fluctuation in the diurnal curve of IOP during the time in which patients received therapy still characterized EXG from POAG.

• Authors: A G Konstas, D A Mantziris, E A Cate, W C Stewart
• Journal: Archives of ophthalmology (Chicago, Ill. : 1960) (Arch Ophthalmol) Vol. 115 Issue 8 Pg. 975-9 (Aug 1997) ISSN: 0003-9950 [Print] United States
• PMID: 9258218 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Adrenergic beta-Antagonists
• Ophthalmic Solutions
• Timolol

Topics

• Adrenergic beta-Antagonists (therapeutic use)
• Aged
• Circadian Rhythm (drug effects, physiology)
• Exfoliation Syndrome (complications)
• Female
• Glaucoma, Open-Angle (drug therapy, etiology, physiopathology)
• Humans
• Intraocular Pressure (drug effects, physiology)
• Male
• Middle Aged
• Ophthalmic Solutions
• Prospective Studies
• Timolol (therapeutic use)