[Quality of life evaluation in elderly normal tension glaucoma patients using the Japanese version of VFQ-25].

PURPOSE: To evaluate the quality of life (QOL) related to the visual functioning of elderly normal-tension glaucoma(NTG) patients quantitatively. SUBJECTS & METHODS: 231 NTG patients 65 years or older with visual field loss in Humphrey visual field analysis were studied. The correlation of the subjects' VFQ-25 scores were studied with their patient background information, as well as with their eye test values for intraocular pressure, corrected visual acuity, refraction, mean deviation (MD), and pattern standard deviation (PSD) in the worst seeing eye. RESULTS: No correlation with the VFQ-25 scores (VFQ-S) was found in any of the 12 sub-scales for gender, age, or duration of the disease. However, the number of glaucoma eye-drop solutions showed a negative correlation with 2 sub-scales. Driving was the only sub-scale in which a correlation was found between the VFQ-S and the subjects' intraocular pressure. Corrected visual acuity demonstrated correlations in many of the sub-scales. MD measurements showed a high correlation with the VFQ-S in all items except general health and ocular pain. On the other hand, no correlation with the VFQ-S was observed in any of the sub-scales for the PSD measurements. CONCLUSION: The VFQ-S of elderly NTG patients showed a high degree of reliability. The VFQ-25 scores were useful and suitable tools for evaluating the QOL of glaucoma patients with visual field and acuity impairment.

Multicenter, Randomized, Investigator-Masked Study Comparing Brimonidine Tartrate 0.1% and Timolol Maleate 0.5% as Adjunctive Therapies to Prostaglandin Analogues in Normal-Tension Glaucoma.

INTRODUCTION: This study compared the efficacy and safety of adjunctive brimonidine tartrate 0.1% ophthalmic solution (brimonidine) and timolol maleate 0.5% ophthalmic solution (timolol) in prostaglandin analogue (PGA)-treated normal-tension glaucoma (NTG), assessing the non-inferiority of brimonidine in terms of intraocular pressure (IOP) reduction. METHODS: In this multicenter, randomized, investigator-masked, parallel-group, clinical study, adjunctive brimonidine or timolol was administered twice daily for 12 weeks in eyes with NTG that had been treated with PGA for at least 90 days and required additional treatment despite an IOP of 16 mmHg or less. IOP was measured on at least three visits before add-on therapy (mean baseline IOP), and at weeks 4, 8, and 12 after adjunctive administration. Systolic/diastolic blood pressure, pulse rate, and adverse events (AEs) were recorded at each visit. RESULTS: A total of 152 individuals were enrolled and 128 (84.2%) were eligible for efficacy analyses. IOP in both groups at each visit decreased significantly from baseline (P < 0.001). However, the difference in the change from baseline IOP at week 12 between the brimonidine (-1.05 ± 1.81 mmHg) and timolol (-1.41 ± 1.40 mmHg) groups was 0.36 mmHg (95% confidence interval [CI] [-0.21, 0.92]), which exceeded the value of the non-inferiority margin (0.75 mmHg). Baseline systolic/diastolic blood pressure decreased significantly in both groups at certain visits (P < 0.05), while baseline pulse rates decreased significantly in the timolol group (P < 0.001), with no significant differences in the brimonidine group. AE-related treatment discontinuation occurred in 2/71 (2.8%) and 2/75 (2.7%) patients in the brimonidine and timolol groups, respectively. CONCLUSION: This study demonstrated an add-on effect of brimonidine to PGAs, although non-inferiority of brimonidine to timolol as adjunctive therapy in PGA-treated NTG in terms of IOP reduction was not observed. Brimonidine was associated with no adverse effects on pulse rate. FUNDING: Senju Pharmaceutical Co., Ltd. TRIAL REGISTRATION: UMIN Clinical Trials Registry identifier, UMIN000014810.

Addition of or switch to topical bunazosin hydrochloride in elderly patients with normal-tension glaucoma: A one-year follow-up study.

PURPOSE: To evaluate the efficacy and safety of 0.01% bunazosin hydrochloride ophthalmic solution (bunazosin) for elderly patients with normal-tension glaucoma (NTG) as an addition to or instead of their previous therapy. METHODS: Bunazosin was administered to NTG patients aged 65 years or over who had been undergoing topical glaucoma therapy. In accordance with the study protocol, intraocular pressure (IOP) and visual field measurement were performed and the safety of the treatment was evaluated periodically between week 0 and week 52 at the five facilities where the study was carried out. RESULTS: Of the 98 enrolled patients, 84 (85.7%) were followed up for 52 weeks. During the follow-up period, IOP significantly and persistently decreased (week 0, 15.0 +/- 2.5 mmHg; week 52, 13.4 +/- 2.4 mmHg, P < 0.0001), but the decrease in mean deviation (MD) was not significant. Although no systemic adverse reactions were observed, local adverse events were noted in 7 of the 98 patients. CONCLUSIONS: The addition of or the switch to bunazosin in elderly NTG patients resulted in a significant reduction of IOP without apparent exacerbation of visual field defects or systemic or local adverse reactions other than conjunctival hyperemia.