Comparison Oftheocular Beta-Blockers

1996 ◽  
Vol 30 (1) ◽  
pp. 43-54 ◽  
Author(s):  
Suellyn J Sorensen ◽  
Steven R Abel
Keyword(s):  
Intraocular Pressure ◽  
Adverse Effects ◽  
Therapeutic Response ◽  
Open Angle Glaucoma ◽  
Beta Blockers ◽  
The Other ◽  
Optic Disk ◽  
Intrinsic Sympathomimetic Activity ◽  
Timolol Maleate ◽  
Local Tolerability

OBJECTIVE: To compare the similarities and differences among the ocular beta-blockers. Important considerations when comparing these agents are the differences in systemic adverse effects, local tolerability, and cost. DATA SOURCE: Information was retrieved from a MEDLINE search of the English-language literature and bibliographic reviews of review articles. Index terms included beta-blockers, glaucoma, timolol, levobunolol, betaxolol, metipranolol, and Carteolol. STUDY SELECTION: Emphasis was placed on eyedrop studies, as well as properly designed and executed clinical trials that assessed dosage, dosing interval, therapeutic response, adverse effects, and cost. DATA EXTRACTION: Data from several studies were evaluated according to the study design, therapeutic response, and adverse effects. DATA SYNTHESIS: Timolol maleate, levobunolol, metipranolol, and Carteolol have similar effectiveness in lowering intraocular pressure; however, levobunolol and timolol gel forming solution may have an advantage of once-daily dosing. Studies have not been published comparing the clinical efficacy of timolol hemihydrate with that of other ocular beta-blockers. Metipranolol is cost effective in treating primary open-angle glaucoma; however, it has been associated with more ocular burning, stinging, and granulomatous anterior uveitis than other agents. The intrinsic sympathomimetic activity of Carteolol has not yet displayed a definite advantage over the other agents in terms of optic disk perfusion and systemic adverse effects. The control of intraocular pressure with betaxolol has not always been as good as with timolol; however, betaxolol has some advantages over timolol and the other topical beta-blockers in terms of systemic adverse effects. CONCLUSIONS: Considering cost, efficacy, and safety, timolol maleate is the recommended formulary agent because the other agents cannot consistently show an outstanding advantage.

scholarly journals Comparative study between timolol maleate and timolol - brimonidine combination in treatment of open-angle glaucoma of moderate intraocular pressure in a tertiary care hospital

2021 ◽  
Vol 8 (2) ◽  
pp. 151-155
Author(s):  
Rashmi Parameswaran ◽  
Satyanarayana V ◽  
Nithisha T M
Keyword(s):  
Intraocular Pressure ◽  
Adverse Effects ◽  
Combination Therapy ◽  
Tertiary Care Hospital ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
Care Hospital ◽  
Open Angle ◽  
Timolol Maleate ◽  
Number Of Patients

To study the efficacy of Timolol Maleate Vs Timolol-Brimonidine combination in lowering the intraocular pressure (IOP) in primary open angle glaucoma (POAG) at a tertiary care hospital. To study any adverse effects of both drug therapies in treatment of POAG. Computerized simple randomization was followed in allocating the patients for the two groups. In each group, n=20, is the total number of patients, and N=30, is the total number of eyes tested, since both eyes were involved in some patients. The concentration of the monotherapy was 0.5% w/v Timolol Maleate and concentration of the combination therapy was 0.2% w/v Brimonidine Tartrate and 0.5% w/v Timolol Maleate. Both drugs were administered twice daily and IOP was recorded every 3 days, for a period of 4 weeks. Monotherapy of Timolol is seen to lower the IOP at 25% in 3 days, whereas the Timolol-Brimonidine combination therapy lowers the IOP at twice the rate that is 50% in 3 days. After reaching a IOP of 12mmHg, which is the normal IOP, both the drugs are used for maintenance therapy. Adverse effects were reported with both groups. Timolol monotherapy is also priced lower, when compared to Timolol-Brimonidine combination therapy. Timolol monotherapy provides the same result as the Timolol-Brimonidine combination therapy and is also comparatively cheaper. Hence, Timolol monotherapy is better suited for the treatment of POAG.

scholarly journals Intraocular Pressure-Lowering Potential of Subthreshold Selective Laser Trabeculoplasty in Patients with Primary Open-Angle Glaucoma

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Hong Yang Zhang ◽  
Yong Jie Qin ◽  
Yang Fan Yang ◽  
Jian Gang Xu ◽  
Min Bin Yu
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Initial Energy ◽  
The Other ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
Pressure Lowering ◽  
Laser Flare

Purpose.To compare the efficacy of subthreshold and conventional selective laser trabeculoplasty (SLT) in lowering intraocular pressure (IOP) in the patients with primary open-angle glaucoma (POAG).Methods.Fifty-two eyes from fifty-two POAG patients were randomized into two groups, one group treated with subthreshold SLT using two-thirds of the conventional energy and the other one treated with the conventional energy. IOP was measured with the Goldmann tonometer and the anterior chamber inflammation was determined using laser flare meter.Results.The initial energy dosage used in subthreshold SLT group was significantly lower than the amount of the energy used in conventional SLT group (0.4±0.1 mJ versus0.6±0.1 mJ,P=0.030). The total energy dosage was also significantly lower in subthreshold SLT group compared to the other group (37.6±3.3 mJ versus51.8±5.7 mJ,P=0.036). However, the level of inflammation in aqueous humor, amount of reduction in IOP, and the success rate in controlling IOP was the same in both groups.Conclusion.The efficacy of subthreshold SLT group in reducing IOP in POAG patients is comparable to the efficacy of conventional SLT group.

Topical Timolol for Infantile Haemangioma of the Orbit

2021 ◽  
Vol 238 (10) ◽  
pp. 1069-1076
Author(s):  
Göran Darius Hildebrand ◽  
Zuzana Sipkova
Keyword(s):  
Adverse Effects ◽  
Beta Blockers ◽  
Close Monitoring ◽  
Line Treatment ◽  
Timolol Maleate ◽  
First Line ◽  
Benign Tumours ◽  
Meta Analyses ◽  
Oral Propranolol ◽  
First Line Treatment

AbstractInfantile haemangiomas (IHs) are the most common benign tumours of the eyelid and orbits in infancy. Beta-blockers, in the form of oral propranolol, have become first-line treatment in severe cases with functionally significant or disfiguring IH. However, adverse drug reactions of oral propranolol in infants are reported in 1 in 11 and serious or potentially life-threatening systemic side effects in 1 in 38, including dyspnoea, hypotension, hyperkalaemia, hypoglycaemia, and cyanosis, therefore requiring careful and close monitoring during the course of systemic treatment. More recently, two large meta-analyses have shown topical beta-blockers, such as timolol maleate 0.5%, to be as effective as oral propranolol in superficial IH, but with no or significantly fewer adverse effects, and have advocated that topical beta-blockers replace oral propranolol as the first-line treatment of superficial IH. We have previously reported the therapeutic response of deep periocular IH to primary topical timolol maleate 0.5% monotherapy. Here we also describe the first successful treatments of large orbital IHs with primary topical timolol maleate 0.5% monotherapy in four infants, resulting in immediate cessation of progression and rapid clinical improvement or resolution in all cases. No adverse effects and no recurrence during long-term follow-up of up to 2.5 years after cessation were seen in any of the patients treated with topical timolol maleate 0.5%.

scholarly journals Twenty-four hour control of intraocular pressure with dorzolamide and timolol maleate in exfoliation and primary open-angle glaucoma

Eye ◽  
2000 ◽  
Vol 14 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Anastasios G P Konstas, ◽  
Athanasios Maltezos ◽  
Theodoros Bufidis ◽  
Alison C Hudgins ◽  
William C Stewart
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Timolol Maleate

scholarly journals Selective Laser Trabeculoplasty Versus Brimonidine Tartrate 0.2%/Timolol Maleate 0.5% As Adjunct Therapy in Primary Open Angle Glaucoma: A Randomized Prospective Trial

2020 ◽  
Author(s):  
Ian McWherter ◽  
Meredith Lanham ◽  
Lee Peplinski ◽  
Nikolaos Zagorianos ◽  
Andrew Steele ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Complication Rates ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Timolol Maleate ◽  
Adjunct Therapy ◽  
Laser Trabeculoplasty ◽  
Brimonidine Tartrate

Abstract Purpose: To compare the intraocular pressure lowering efficacy of selective laser trabeculoplasty to brimonidine tartrate 0.2%/timolol maleate 0.5% in patients with uncontrolled primary open-angle glaucoma on a prostaglandin analog alone. A secondary outcome was to evaluate the complication rates of selective laser trabeculoplasty.Patients and Methods: Twenty-three patients were randomized to two treatment groups within this prospective, observer-masked single site, all optometrist, pilot study. Group 1 (N=12) received 360 degrees of selective laser trabeculoplasty as additional treatment while Group 2 (N=11) was started on FCBT. Outcomes of both groups were measured at eight weeks.Results: Both treatment regimens were found to be statistically significant in lowering IOP when used as adjunct therapy. The average IOP reduction for Group 1 and Group 2 was 28.4% (SD = .17) and 28.2% (SD = .12) respectively. The incidence of an intraocular pressure spike following SLT in this patient population was found to be 8.3%. No major complications were observed in this study.Conclusion: Selective laser trabeculoplasty and brimonidine tartrate 0.2%/timolol maleate 0.5% were shown to be equivalent in lowering intraocular pressure in uncontrolled primary open angle glaucoma patients when used as adjunct therapy for patients on a prostaglandin analog. Additionally, this is the first prospective study of optometrists performing selective laser trabeculoplasty. Although this study had a small sample size, the results appeared to show that efficacy and complication rates were comparable to previously published data; however, these results need to be confirmed with a larger multi-centered trial.Trial Registration: ISRCTN Study ID ISRCTN30070325, retrospectively registered 12/14/2018. http://www.isrctn.com/ISRCTN30070325.

scholarly journals What was Glaucoma Called before the 20th Century?

2015 ◽  
Vol 7 ◽  
pp. OED.S32004 ◽  
Author(s):  
Christopher T. Leffler ◽  
Stephen G. Schwartz ◽  
Francesca M. Giliberti ◽  
Matthew T. Young ◽  
Dennis Bermudez
Keyword(s):  
Intraocular Pressure ◽  
Optic Neuropathy ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
The Other ◽  
Angle Closure ◽  
Open Angle ◽  
Poor Vision ◽  
Elevated Intraocular Pressure

Glaucoma involves a characteristic optic neuropathy, often with elevated intraocular pressure. Before 1850, poor vision with a normal eye appearance, as occurs in primary open-angle glaucoma, was termed amaurosis, gutta serena, or black cataract. Few observers noted palpable hardness of the eye in amaurosis. On the other hand, angle-closure glaucoma can produce a green or gray pupil, and therefore was called, variously, glaucoma (derived from the Greek for glaucous, a nonspecific term connoting blue, green, or light gray) and viriditate oculi. Angle closure, with palpable hardness of the eye, mydriasis, and anterior prominence of the lens, was described in greater detail in the 18th and 19th centuries. The introduction of the ophthalmoscope in 1850 permitted the visualization of the excavated optic neuropathy in eyes with a normal or with a dilated greenish-gray pupil. Physicians developed a better appreciation of the role of intraocular pressure in both conditions, which became subsumed under the rubric “glaucoma”.

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