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J. F. Casiraghi, D. E. Grigera, P. Hernandez, A. Peyret; Fixed Combination Therapy and Treatment Schemes among the Various Glaucoma Diagnoses: A Multicentric, Cross-sectional Glaucoma Study in Buenos Aires, Argentina. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4087.
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To assess the number and type of antiglaucomatous medications applied and the rate of use of these medications in the whole population and in each glaucoma diagnosis in outpatients from 4 urban hospitals in Buenos Aires, Argentina.
741 consecutive patients under glaucoma care in 4 hospitals in Buenos Aires during September/October 2007 were included. Patients underwent interview and complete glaucoma examination. Data on diagnoses and on medical antiglaucomatous schemes useful for this report were processed.
One hundred and eighty four patients (24.83%) were untreated at the time of the examination; all of them were either glaucoma suspects or undergoing initial study. Two hundred and seventy two (36.71%) were using only one medication, 285 (38.46%) two or more medications, and of these 43 (5.80%) were under three or more medications. Prostaglandin analogues (PGA) were the most frequently used group in all patients: 303 (40.89%), second place was for fixed combinations with timolol plus a non-PGA: 282 (38.06%), beta blockers came thereafter: 137 (18.49%) followed by topic CAIs 41 (6.61%), alpha agonists 38 (5.13%), acetazolamide 28 (3.78%), and pilocarpine 19 (2.56%). The least used treatment was fixed combinations with timolol plus a PGA: 17 (2.29%). As for specific glaucoma diagnoses, PCAG had the highest rate of use of PGAs (56.58%) and also the highest rate of use of topic CAIs (10.53%) and the lowest of beta blockers (14.47%) and pilocarpine: 2 (0.65%). POAG had the lowest rate of use of pilocarpine 2 (0.65%) and of alpha agonists: 11 (3.55%) Pseudoexfoliation glaucoma had the highest rate of use of fixed combinations with timolol plus a non-PG: 56 (46.28%), the highest rate of fixed combinations with a PGA: 5 (4.13%) and the lowest of topic CAIs: 8 (6.61%)
a) Less than forty percent of the patients had fixed combination therapy in their regime, b) more than one third were on monotherapy and scarcely less than six percent used more than three medications, d) the single most used medication type were PGAs and the least used were fixed combinations with timolol plus a PGA e) PCAG had the highest rate of use of PGAs and pseudoexfoliation-associated glaucoma had the highest rate of use of fixed combinations.
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