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GR Paris, WE Sponsel, Y Trigo, M Pena; Comparative Effects of Latanoprost and Unoprostone on IOP, Visual Function, and POBF in Open Angle Glaucoma . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4114.
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Purpose: To compare latanoprost with unoprostone for their effects on IOP, visual function, and pulsatile ocular blood flow, among glaucoma patients in a single-center, prospective randomized clinical trial. Methods: 25 adults with open-angle glaucoma underwent morning (8-10am) and afternoon (1-3pm) measurements of intraocular pressure, pulsatile ocular blood flow (POBF), NeuroScientific temporally modulated 1- and 4-cpd contrast sensitivity testing, Frequency Doubling Technology (FDT) full-threshold testing, and Humphrey SITA full threshold 10-2 perimetry in both eyes. Each then started unoprostone 0.15%. (Rescula) in one randomly assigned eye and latanoprost 0.005% (Xalatan) in the other. Unoprostone was administered at 8 am and 8 pm, and latanoprost at 8 pm with placebo at 8 am, from masked bottles. After 28 days, differences were determined for each measured variable by 2-tailed paired-t test. Results: On day 28, mean morning applanation pressures were 2.6 mmHg lower than baseline in the eyes receiving latanoprost (P<0.0001), and 1.6 mmHg lower in unoprostone-treated eyes (P=0.02). The concluding a.m. IOP values (16.2 +/-0.6 mmHg for latanoprost; 17.9 +/-0.7 for unoprostone) were significantly different (P=0.001). Afternoon values were 3.1 and 2.3 mmHg lower than corresponding baseline, respectively (P<0.0001 from baseline for both; interdrug difference; P=0.04). POBF increased 30% relative to baseline with latanoprost, (P<0.0001) and 16% with unoprostone (P=0.05) in the morning, and afternoon POBF increases were 30% (P<0.0001) for latanoprost and 18% (P=0.03) for unoprostone (inter-drug difference P=0.05). Eyes receiving unoprostone showed a statistically significant increase in FDT mean deviation between baseline and day 28, from -2.4 +/-1.1 to -0.7 +/-0.8 decibels. This 1.7 decibel mean improvement was significant (P = 0.03). Humphrey 10-2 SITA threshold perimetry and contrast sensitivity remained stable with both prostaglandin analogues. Conclusion: Both drugs produced significant reductions in IOP and increases in POBF, with stable or improved central and perimacular visual function. Latanoprost once daily produced changes nearly 2-fold greater than those obtained with unoprostone twice daily for both IOP and POBF. These differences were statistically significant.
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