Around-the-clock intraocular pressure reduction with once-daily application of latanoprost by itself or in combination with timolol

P. Racz, M. R. Ruzsonyi, Z. T. Nagy, Z. Gaygi and L. Z. Bito
Department of Ophthalmology, Markusovszky Hospital, Szombathely, Hungary.

OBJECTIVE: To determine whether once-daily, in the morning, topical application of the new ocular hypotensive prostaglandin analogue, latanoprost, yields nocturnal intraocular pressure (IOP) reduction similar to its diurnal IOP reducing efficacy. STUDY DESIGN AND PATIENTS: Placebo- controlled, randomized, and double-masked study on hospitalized patients with ocular hypertension or glaucoma. Patients in group 1 (n=9) were maintained on twice-daily applications of 0.5% timolol maleate. Patients in group 2 (n=10) terminated their timolol treatment 3 weeks before the beginning of the study. In both groups the test drug (0.005% latanoprost) and its vehicle (placebo) was applied by hospital staff every morning for 9 days. MEASUREMENTS: After 4 days of ambulatory treatment, patients were hospitalized, and IOP values were obtained in the supine and sitting positions with a handheld electronic tonometer (Tono-Pen XL, Bio-Rad, Glendale, Calif) and a Goldmann's applanation tonometer, covering every 2-hour interval, around the clock, but not more than at four time points per day during a 5-day period. RESULTS: The mean nocturnal IOPs (Goldmann's applanation tonometer) collected for 5 days were mean +/-SEM 17.9+/-0.6 vs 20.2+/-0.6 mm Hg and 16.8+/-0.3 vs 20.6+/-0.5 mm Hg for the study vs the control eyes in group 1 and group 2, respectively. These nocturnal IOP reductions were statistically significant (P<.001, two-tailed paired Student's t test). The differences between diurnal and nocturnal IOP reductions (handheld electronic or Goldmann's applanation tonometer) were minimal (>0.3 mm Hg) and statistically not significant (P>.31, two-tailed paired Student's t test). CONCLUSION: Once-daily latanoprost treatment provides uniform circadian (around-the-clock) IOP reduction by itself, or in combination with timolol.

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