Twenty-four-hour effects of bimatoprost 0.01% monotherapy on intraocular pressure and ocular perfusion pressure.

OBJECTIVES: To investigate the 24 h effects of bimatoprost 0.01% monotherapy on intraocular pressure (IOP) and ocular perfusion pressure (OPP). DESIGN: Prospective, open-label experimental study. SETTING: Single tertiary ophthalmic clinic. PARTICIPANTS: Sixteen patients with diagnosed primary open-angle glaucoma (POAG) or ocular hypertension (ages, 49-77 years). INTERVENTIONS: Baseline data of 24 h IOP in untreated patients were collected in a sleep laboratory. Measurements of IOP were taken using a pneumatonometer every 2 h in the sitting and supine body positions during the 16 h diurnal/wake period and in the supine position during the 8 h nocturnal/sleep period. After baseline measurements were taken, patients were treated with bimatoprost 0.01% one time per day at bedtime for 4 weeks, and then 24 h IOP data were collected under the same laboratory conditions. PRIMARY AND SECONDARY OUTCOME MEASURES: Diurnal and nocturnal IOP and OPP means under bimatoprost 0.01% treatment were compared with baseline. RESULTS: The diurnal and nocturnal IOP means were significantly lower under the bimatoprost 0.01% treatment than baseline in both the sitting and supine positions. The diurnal and nocturnal OPP means were significantly higher under treatment than baseline in both the sitting and supine positions. CONCLUSION: Bimatoprost 0.01% monotherapy significantly lowered IOP and increased OPP during the 24 h period.

Diurnal and nocturnal effects of brimonidine monotherapy on intraocular pressure.

PURPOSE: To investigate the effect of brimonidine monotherapy on intraocular pressure (IOP) during the nocturnal/sleep period. DESIGN: Prospective, open-label experimental study. PARTICIPANTS: Fifteen patients with newly diagnosed open-angle glaucoma or ocular hypertension (ages, 46-72 years). METHODS: Baseline data of 24-hour IOP in untreated patients were collected in a sleep laboratory. Measurements of IOP were taken using a pneumatonometer every 2 hours in the sitting and supine body positions during the 16-hour diurnal/wake period and in the supine position during the 8-hour nocturnal/sleep period. Patients were treated afterward with 0.1% brimonidine 3 times per day for 4 weeks, and 24-hour IOP data were collected under the same laboratory conditions. MAIN OUTCOME MEASURES: Diurnal and nocturnal IOP means under the brimonidine treatment were compared with the baseline. RESULTS: The diurnal IOP mean was significantly lower under the brimonidine treatment than the baseline IOP in both the sitting and supine positions. There was no statistically significant change in IOP under the brimonidine treatment from the baseline during the nocturnal period. CONCLUSIONS: Although 0.1% brimonidine monotherapy significantly lowered IOP during the diurnal/wake period, it did not significantly lower IOP during the nocturnal/sleep period. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

Comparing diurnal and nocturnal effects of brinzolamide and timolol on intraocular pressure in patients receiving latanoprost monotherapy.

PURPOSE: To compare the diurnal and nocturnal effects of brinzolamide and timolol on intraocular pressure (IOP) in patients already receiving monotherapy with latanoprost. DESIGN: Prospective, open-label, and crossover clinical trial. PARTICIPANTS: Twenty-six patients with glaucoma or ocular hypertension (ages, 44-79 years) who were receiving treatment with 0.005% latanoprost once every evening. METHODS: Baseline data of 24-hour IOP were collected in a sleep laboratory while patients were receiving latanoprost monotherapy. Measurements were taken every 2 hours in the sitting and supine positions during the 16-hour diurnal/wake period and in a supine position during the 8-hour nocturnal/sleep period. Patients were randomly assigned to receive an add-on treatment with either 1% brinzolamide 3 times per day or 0.5% timolol gel forming solution once every morning for 8 weeks, and then crossed over to receive the other add-on treatment. At the end of each add-on treatment period, 24-hour IOP data were collected. MAIN OUTCOME MEASURES: Diurnal and nocturnal IOP means were compared among the baseline, the brinzolamide add-on treatment, and the timolol add-on treatment. RESULTS: During the diurnal period, the mean IOP under brinzolamide or timolol add-on treatment was significantly lower than the baseline IOP in both the sitting and supine positions. There was no statistical difference between the 2 add-on treatments. During the nocturnal period, the supine IOP under brinzolamide add-on treatment was significantly lower than both the baseline and the timolol add-on treatment. There was no difference in nocturnal IOP between the timolol add-on treatment and the baseline. CONCLUSIONS: In patients already receiving the latanoprost monotherapy, adding brinzolamide or timolol significantly reduced IOP during the diurnal period. However, only the brinzolamide add-on treatment had an IOP-lowering efficacy during the nocturnal period.