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Paolo Nucci, Matteo Sacchi, Andrea Lembo, Stefano Ranno; Diurnal Intraocular Pressure Fluctuation With Travoprost And Timolol, Bimatoprost And Timolol And Latanoprost And Timolol Fixed Combination Administered In The Morning Or Evening. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5102.
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To evaluate differences in diurnal intraocular pressure (IOP) fluctuation using travoprost /timolol fixed combination (TTFC), bimatoprost/timolol fixed combination (BTFC) or latanoprost/timolol fixed combination (LTFC) administered in the morning or evening in primary open-angle glaucoma (POAG).
We retrospectively analyzed diurnal IOP of 112 glaucoma patient assuming TTFC (n=36), BTFC (n=38) or LTFC (n=38) administered in the morning and switched to evening administration for compliance reasons. IOP was assessed by diurnal curve (8AM, 11AM, 2PM, 5PM, 8PM) in patients treated with morning administration for at least 3 months and 3 months after the switch to evening administration. For the IOP recording, the mean values of 2 measurements at each time point were used.Diurnal IOP fluctuation was assessed as highest daily IOP value -lowest daily IOP value.
Mean diurnal IOP was similar between morning and evening administration for TTFC (18.6+/-2.6 vs 18.1+/-2.3, p > 0.05), BTFC (17.6+/-2.4 vs 16.9+/-2.3, p > 0.05) and LTFC (18.7+/-2.5 vs 18.3+/-2.4, p > 0.05). IOP at 8 AM was significantly higher in the morning administration of TTFC, BTFC and LTFC (p < 0.05). Diurnal fluctuation was significantly lower with the evening administration of fixed combinations compared to morning administration for TTFC (3.2+/-1.3 vs 5.1+/-1.6, p < 0.05), BTFC (2.9+/-1.2 vs 4.9+/-1.5, p < 0.05) and LTFC (3.3+/-1.6 vs 5.2+/-1.7, p < 0.05).
Both morning and evening dosing of TTFC, BTFC and LTFC were effective in lowering diurnal IOP in patients with POAG. However, evening dosing seemed to be more effective in controlling IOP especially in the morning and avoiding the fluctuations with lower range of IOP.
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