June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Chronic Prostaglandin Analogue Treatment Persistently Depresses Intraocular Pressure Following Washout
Author Affiliations & Notes
  • Vlad Diaconita
    Ophthalmology, University of Western Ontario, London, ON, Canada
    Ivey Eye Institute, London, ON, Canada
  • Eddie Y Liu
    Ivey Eye Institute, London, ON, Canada
  • Jillian Belrose
    Schulich School of Medicine and Dentistry, London, ON, Canada
  • Cindy M L Hutnik
    Ophthalmology, University of Western Ontario, London, ON, Canada
    Ivey Eye Institute, London, ON, Canada
  • Footnotes
    Commercial Relationships Vlad Diaconita, None; Eddie Liu, None; Jillian Belrose, None; Cindy Hutnik, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5705. doi:
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    • Get Citation

      Vlad Diaconita, Eddie Y Liu, Jillian Belrose, Cindy M L Hutnik, ; Chronic Prostaglandin Analogue Treatment Persistently Depresses Intraocular Pressure Following Washout. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5705.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To assess whether chronic treatment with prostaglandin analogues in individuals with primary open angle<br /> glaucoma produces a long lasting depression of intraocular pressure (IOP) relative to baseline IOP.

 
Methods
 

A total of 180 eyes from individuals aged 18 years and older with primary open angle glaucoma and an<br /> elevated intraocular pressure who are treated chronically (>6 months) with a single intraocular prostaglandin analogue (PGA) were recruited to the study. Individuals were randomized to either continue with their current medication therapy or discontinue treatment. Intraocular pressure was measured at the time of randomization, and at 1, 3, and 6 week time points following randomization. These results were compared with baseline IOP (prior to initiation of glaucoma treatment). A subgroup analysis assessed the effects of chronic prostaglandins in individuals treated with PGA alone, PGA + SLT, PGA + peripheral iridotomy, and PGA + pseudophakia. A repeated measures ANOVA followed by a post-hoc Sidak’s test for multiple comparisons was used for statistical analysis. Data were expressed as mean ± SE. This study was funded by a grant from CNIB-CGCRC.

 
Results
 

Interim results show that in the washout group, the mean baseline IOP was 26.6 ± 1.6 mmHg. Following<br /> chronic PGA treatment, this was significantly decreased to 14.5 ± 0.6 mmHg (p<0.001). After a 6 week washout<br /> period, the mean IOP was 20.3 ± 2.6 mmHg. This was significantly lower than baseline IOP (p<0.05). As expected, the control group who continued with their current medical therapy also demonstrated a decrease in IOP following chronic PGA treatment which did not change during the 6 week study period.

 
Conclusions
 

This is the first study to assess the long term effects of PGA on IOP following medication washout. The results demonstrate a persistent effect on IOP lowering following a 6 week period of discontinuation of PGAs. Analyses to determine whether specific patient factors may predict response to chronic PGA treatment will be presented. This information could be used to “custom tailor” treatment decisions, and also to identify whether certain factors should be stratified and considered in glaucoma clinical trials.  

 
Figure 1. Study Design
 
Figure 1. Study Design

 
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