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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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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.
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.
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.
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.
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