The Effect of Brimonidine 0.1% on Disc Hemorrhage in Primary Open-Angle Glaucoma Patients.

BACKGROUND: This retrospective study evaluated the effect of adjunctive administration of brimonidine 0.1% on disc hemorrhage (DH) in patients with primary open-angle glaucoma or normal-tension glaucoma who were already treated with other anti-glaucoma drugs. METHODS: Patients with DH, before adjunctive therapy with brimonidine, were enrolled. Subjects were excluded if their treatment regimen was changed within 1 year after initiation of adjunctive therapy with brimonidine. We investigated the frequency of DH and intraocular pressure (IOP). Both parameters were compared before and after adjunctive administration of brimonidine. RESULTS: The frequency of DH before and after brimonidine administration was 0.67±0.68 and 0.31±0.72 times/year, respectively, with a significant decrease (P=0.01), and the mean IOP before and after brimonidine administration was 12.5±1.9 and 11.2±2.2 mmHg, respectively, (P=0.0006) with a significant reduction after adjunctive administration. CONCLUSION: The results of this study supported the hypothesis that the frequency of DH is reduced by brimonidine alongside lowering of IOP.

Effects of a contact lens subscriber replacement program on patient lens care behavior in Japan.

PURPOSE: Compliance with practitioner recommended lens care guidelines was assessed and compared in two test groups: patients belonging to a subscription membership group and a nonaffiliated group of 2-week frequent replacement (2WFR) soft contact lens wearers. METHODS: Wearers (143 members and 149 nonmembers), whose clinical records were available for 18-24 months from September 2010 to August 2012, were queried by a written questionnaire: (1) source of lens purchase; (2) "rub" or "no-rub" care solution; (3) replacement interval of lens care products; (4) lens cleaning method; (5) noncompliant behaviors; and (6) replacement frequency of lens storage cases. RESULTS: The questionnaires were completed by 104 members and 100 nonmembers. Of member group wearers, 63.0% correctly recognized the types of lens care products used ("rub', "no-rub") vs. 77.4% of nonmembers. Of member wearers, 82.2% used "rub" and rubbed each time vs. 76.3% of nonmembers. The replacement interval for care products was 26.2% (members) and 27.6% (nonmembers) for 1 month or less, while replacement frequency of storage cases was 22.3% and 19.2% for 1 month or less in each group respectively. There were no significant differences observed between each of these group comparisons (p>0.05, Fisher exact test). CONCLUSIONS: Compliance with practitioner recommended lens care regimens was equally poor in both test groups. Subscription membership of CLs which does not provide lens care products is not accompanied by an increase in compliance with lens care practices.

Compliance study of contact lens wearers in Japan--part 2: evaluation of a subscribed membership system.

OBJECTIVE: To examine the hypothesis that membership in a contact lens (CL) supply system is associated with better compliance for regular wearers (members) who belong to the subscription membership system. METHODS: Subjects were 104 members and 100 nonmember wearers of 2-week frequent replacement silicone hydrogel CLs whose clinical information was retrospectively available for 1.5 to 2 years in the interval between September 2010 and August 2012. The average duration of use of a single lens was calculated from the number of lenses supplied during the observation period and surveyed using questionnaires. Subjective symptoms and eye complications were also documented and compared. RESULTS: The average duration of use of a lens was significantly longer in nonmembers (17.8±5.6 days/lens; n=91) than in members (14.2±3.5 days/lens; n=98) (P<0.001, Mann-Whitney U test). The number of wearers who replaced their lenses within 15.4 days per lens wear was significantly higher in members (74.5%) as compared with nonmembers (45.1%) (P<0.001, Fisher exact test). Levels of compliance reported by wearers did not match with those indicated in clinical records. In recorded eye complications, the rate of incidence of allergic and giant papillary conjunctivitis tended to be higher in nonmembers as compared with members. CONCLUSIONS: The hypothesis that a membership system could be associated with better compliance was found to be supported by clinical records. It is suggested that a membership system is useful for identifying wearers who want to be more compliant and that better compliance may reduce long-term complications of lens wear.

Compliance study of contact lens wearers in Japan, part 1: internet survey of actual circumstances of lens use.

PURPOSE: To conduct a survey of contact lens (CL) wearers who use their CLs with satisfaction in Japan and to establish the actual circumstances of CL use. METHOD: An Internet survey was conducted in 1,000 CL wearers in Japan with questionnaires concerning CL purchase/change, compliance with the duration of wear, and occurrence of complications of CL use. RESULTS: Replies from 636 women (63.6%) and 364 men (36.4%) were received. The largest source of CL purchase was CL specialty stores (eyeglass chains, 41.3%). The most frequent CL types were 2-week frequent replacement (2WFR) soft CLs (SCLs) (32.1%), daily disposable (DD) (31.0%), and other lenses. The main determining factors of purchase were "price" (38.0%), "recommendation of a doctor/staff" (37.6%), and "comfort" (34.1%). The number of wearers who changed their CLs was 372 (37.2%), and the main reasons for change were "inexpensive" (34.9%) and "recommendation of a doctor/staff" (31.2%). In DD and 2WFR/planed replacement SCLs, 270 (42.7%) of 632 wearers were compliant with the recommended duration of use, and the remainder were self-identified as noncompliant. The main reason given for noncompliant behavior was "no harm in extending the duration of use" (60.3%). The number of wearers with eye complications related to lens was 373 (37.3%). CONCLUSIONS: The choice of CLs by wearers seems to be price driven rather than being safety focused. Despite being aware of noncompliant behaviors regarding CL use, there were many noncompliant wearers. Clearly, ophthalmologists, optometrists, CL manufacturers, and other CL-related practitioners should cooperate and better educate patients to promote the importance of compliance with safe lens use.