scholarly journals Prescribing trends of anti glaucoma medication usage in treatment naive patients of primary open angle glaucoma in a tertiary care hospital in Eastern India

2018 ◽  
Vol 7 (5) ◽  
pp. 971
Author(s):  
Aditi Maitra ◽  
Shashwat Bhattacharyya ◽  
Shatavisha Mukherjee ◽  
Nikhil Era ◽  
Sambuddha Ghosh ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Treatment Guidelines ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
Fixed Dose ◽  
Care Hospital ◽  
Open Angle ◽  
Entire Study ◽  
Prescribing Trends ◽  
Treatment Naïve

Background: Primary open angle glaucoma remains a high magnitude healthcare problem due to its prevalence and chronicity. The real world scenario of anti glaucoma medical therapy needs periodical auditing as far as drug prescriptions are concerned for formulation of treatment guidelines. Few studies from India have taken a longitudinal approach in this respect. This study was undertaken to identify such lacunae.Methods: This was an open label, prospective, observational study. Each treatment naive patient was followed up for a period of 6 months, where their prescriptions were scanned for the type of the anti glaucoma medications, total number of medications, route of administration, their duration of use and their frequency of dosage and change in medications if any, in each visits.Results: A gradual shift from monotherapy towards combination therapy was observed. Overall averages for prescriptions were topped by monotherapy at 44.25 followed by fixed dose combinations at 38.25, and then combination-polytherapy at 36 and the least number of prescriptions were for concurrent polytherapy at 17.5. Amongst all monotherapy agents, beta blockers were the most frequently prescribed drugs at baseline but their share of prescriptions was almost halved at the end of our study. The prostaglandin analogs on the other hand saw an upsurge in prescriptions from their baseline to the end of this study. Prostaglandin analogs andbeta blockers as fixed dose combination was a popular prescription over the entire study duration.Conclusions: Prescribing trends were remarkable for the shift from primary monotherapy towards fixed dose combinations as the study concluded. The decline in the number of beta blocker prescriptions and a rise in prostaglandin analog prescriptions is a testament to their better effectiveness and tolerability. The future of open angle glaucoma pharmacotherapy lies in prescribing more efficacious drugs either in monotherapy or in fixed combinations.

scholarly journals Outcome of Conventional Trabeculectomy in Terms of Intraocular Pressure and Visual Acuity in Primary Open Angle Glaucoma

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Erum Shahid ◽  
Uzma Fasih ◽  
Arshad Shaikh
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Tertiary Care Hospital ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Open Angle ◽  
Retrobulbar Anaesthesia

Purpose:  To determine the outcomes of conventional trabeculectomy in terms of decrease in Intra Ocular Pressure (IOP) and improvement in visual acuity in patients of primary open glaucoma, coming to a tertiary care hospital. Study Design:  Retrospective case series. Place and Duration of Study:  Ophthalmology department of a tertiary care hospital from January 2017 to December 2018. Methods:  Patients undergoing trabeculectomy for Primary open angle glaucoma were included. Patients with repeated trabeculectomy, failed argon laser trabeculoplasty, advance cataract, corneal opacities and absolute glaucoma were excluded. All the trabeculectomies were done under retrobulbar anaesthesia after taking all aseptic measures. Primary outcome measures were preoperative and postoperative visual acuity, intraocular pressure, number of antiglaucoma medications and failed or successful trabeculectomy. Results:  Total 52 patients underwent trabeculectomy. There were 36 (69.2%) males and 16 (30.8%) females. Mean age was 56.73 years ± 10.9 SD. Mean preoperative IOP was 30.96 ± 6.71 mm Hg, post operatively IOP at 1 year it was 15.6 ± 4.2 mm Hg. P value was <.000. Mean number of antiglaucoma medications was 3.03 and 1.19, pre and post-operatively respectively (p value <.000). Improvement in visual acuity after trabeculectomy was seen in 32 (61.5%) patients. Complete Surgical success was seen in 28 (53.8%) and qualified success in 21 (40.4%) patients. Failed trabeculectomy was seen in 3 (5.8%) patients. Conclusion:  Conventional trabeculectomy is effective in lowering IOP in primary open angle glaucoma patients. It maintains IOP within normal range with and without anti-glaucoma medications at 1 year follow-up. Trabeculectomy significantly reduces number of anti-glaucoma medications. Key Words:  Intraocular pressure, Primary open angle glaucoma, Trabeculectomy.

scholarly journals TO STUDY THE DRUG USE PATTERN IN PRIMARY OPEN ANGLE GLAUCOMA IN A TERTIARY CARE TEACHING

2017 ◽  
Vol 10 (2) ◽  
pp. 198
Author(s):  
Deepalatha C ◽  
Leela Pratyusha Mb
Keyword(s):  
Drug Use ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Open Angle ◽  
Duration Of Treatment ◽  
Care Teaching ◽  
Dose Combination

Objective: To study the drug utilization pattern in patients suffering from primary open-angle glaucoma (POAG) in a tertiary care teaching hospital.Methods: It is a prospective study done on 50 patients of POAG (comprising of individuals belonging to any age group). This study was carried for a period of 2-month, and the data included patient’s demographic details and the drugs prescribed. Data were analyzed for drug use pattern.Results: After screening the prescriptions of patients, it was found out that out of total 50 prescriptions, 30 were males, and 20 were females. Out of50 prescriptions, prostaglandins (58%) were most commonly prescribed. β-blockers (16%) were also prescribed. Fixed dose combination constituted60% of the prescriptions. Instructions about the route, frequency, and duration of treatment were present in all prescriptions. Drugs prescribed by their generic names were 18.75% and about 81.25% of the drugs were prescribed by their brand names.Conclusions: Fixed drug combination of timolol and dorzolamide was the most frequently prescribed combination. Prescribers must be aware ofimportance of prescribing drugs with generic names.Keywords: Primary open-angle glaucoma, Intraocular pressure, Fixed dose combination.

scholarly journals A drug utilization study in glaucoma patients in ophthalmology out patient department in a tertiary care hospital

2017 ◽  
Vol 6 (8) ◽  
pp. 1955
Author(s):  
Kaushal B. Patel ◽  
Gurusharan H. Dumra ◽  
Adarsh Jeet Singh ◽  
Abhishek Vyas ◽  
Chetan G. Parmar
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Common Variant ◽  
Fixed Dose Combination ◽  
World Health ◽  
Fixed Dose ◽  
Care Hospital ◽  
Open Angle ◽  
Dose Combination ◽  
Patient Department

Background: According to World Health Organization (WHO) studies Glaucoma is a chronic progressive symptomatic disease that damages retinal cells and is one of the leading cause of preventable blindness worldwide. Availability of newer topical agents has modernized the management of glaucoma.Methods: A prospective observational study was carried out from August 2016 to December 2016 at ophthalmology Out Patient Department of L.G General Hospital, Ahmedabad by authours after the approval of the Institutional Ethics Committee.Results: Out of total 101 patients, 71 were males and 30 were females. Average age of patient is 54 years. Common variant of Glaucoma was Primary Open Angle Glaucoma in 57.4% of patients. Average number of drugs per prescription was 2 (45%). Most commonly used Fixed Dose Combination was Brimonidine +Timolol Drops which was used in 87 (86.1%) patients. Most commonly used adjuvant drug was Tab. Acetazolamide (60% of patients).Conclusions: Common variant of Glaucoma was Primary Open Angle Glaucoma in 57.4% of patients. Most commonly used Fixed Dose Combination was Brimonidine+Timolol Drops which was used in 87 (86.1%) patients and commonly used Single drug therapy is Tab. Acetazolamide in (60% of patients).

scholarly journals Efficacy and safety of topical BAK-free travoprost 0.004% versus BAK-preserved travoprost 0.004% in the treatment of primary open angle glaucoma: a comparative study at a tertiary care hospital

2017 ◽  
Vol 6 (9) ◽  
pp. 2199 ◽  
Author(s):  
Jayanthi C. R. ◽  
Divyashree R. N. ◽  
Sujatha B. L.
Keyword(s):  
Ocular Surface ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
Ocular Surface Disease ◽  
Care Hospital ◽  
Open Angle ◽  
Ocular Surface Disease Index ◽  
Significant Difference ◽  
Monitoring Treatment

Background: Prostaglandin analogues (PGAs) reduce intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG); however, these medications may affect the ocular surface and elicit ocular discomfort when preserved with benzalkonium chloride (BAK). Hence the above study was taken to evaluate the benefit of BAK-free formulations of travoprost. The objectives of the study were to compare the efficacy, safety of topical BAK-free travoprost 0.004% versus BAK-preserved travoprost 0.004% in patients with primary open angle glaucoma.Methods: 40 patients with POAG who fulfilled the inclusion /exclusion criteria were randomised into two groups of 20 each to receive BAK-free travoprost 0.004% or BAK-preserved travoprost once daily in the evening. Efficacy was measured in terms of reduction in IOP monitored at 4, 8 and 12 weeks from baseline. Ocular surface disease index (OSDI) questionnaire was used to assess the ocular surface symptoms. Safety was assessed by monitoring treatment emergent adverse drug reactions (ADRs).Results: Both the study medications were effective in reducing IOP when compared to baseline. Mean IOP reduction from baseline to week 12 was 11±3mmHg (p <0.001), 10.78±3.01mmHg, (p<0.001) in BAK-free travoprost and BAK-preserved travoprost groups respectively. Both produced equivalent reductions in IOP at the end of 4 (7.89±1.82 vs 7.63±2.83, p=0.72), 8 (9.94±2.75 vs10.05±2.75, p=0.90), and 12 weeks (11±3 vs10.78±3.01, p=0.82). BAK-free travoprost demonstrated significantly lower OSDI scores (15.10±3.60) compared to BAK- preserved travoprost (23.47±7.10) at 12 weeks (p <0.0001). There was no significant difference in occurrence of conjunctival hyperaemia between the study drugs (c2 = 0, df = 1, p = 1) and BAK-free travoprost was well tolerated.Conclusions: BAK-free and BAK-preserved travoprost significantly reduced IOP at 12 weeks. But, BAK- free travoprost produced significantly less ocular surface symptoms as compared to BAK- preserved travoprost. Hence it could be a favourable option in POAG patients with ocular surface disease symptoms.

scholarly journals A COMPARATIVE STUDY OF TOPICAL BETAXALOL AND TIMOLOL FOR THEIR EFFICACY AND SIDE EFFECTS

2018 ◽  
Vol 4 (3) ◽  
pp. 6-9
Author(s):  
Shobhana Jorvekar ◽  
Mallikarjun Salagar ◽  
Akshay Bhandari
Keyword(s):  
Comparative Study ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
Ophthalmic Solution ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Open Angle ◽  
Timolol Maleate ◽  
Applanation Tonometer

Purpose: Primary open angle glaucoma (POAG) is one such field in Ophthalmology where ophthalmologists have failed to stop blindness due to it. All the available treatment modalities are directed towards the reduction of intraocular pressure (IOP) but without interfering the basic aetiopathogenesis. In this study we propose to study efficacy, potency and adverse effects of topical Timolol and Betaxalol in primary open angle glaucoma.  Methodology: A comparative study of topical Betaxalol 0.5% and Timolol 0.5% in the management of POAG was conducted at Tertiary care hospital. Fifty patients of newly diagnosed POAG of different age, sex, religion from both urban and rural population attending eye OPD were included in this study. 25 patients were treated with topical Timolol maleate 0.5% ophthalmic solution BD and 25 patients were treated with topical 0.5% Betaxalol hydrochloride phthalmic solution BD. At 20 weeks follow up IOP levels n both the groups measured by applanation tonometer were compare to each other.  Results: In this study a total of 50 patients with POAG were studied. 25 patients were treated with Timolol maleate 0.5% ophthalmic solution and 25 patients were treated with 0.5% Betaxalol hydrochloride ophthalmic solution. Out of 50 patients, 29 (58%) were male and 21(42%) were female patients. POAG was most common in the age group of 51-60 years with average age 51.50 (S.D. 9.8) years. Average age in males was 54.50 years, while in female it was 49.31 years. Conclusion: both Timolol and Betaxalol are effective in decreasing IOP in POAG patients. The magnitude of Timolol in decreasing IOP is more as compared to Betaxalol. The selective beta 1 adrenergic inhibition of Betaxalol provides an added benefit for those patients in whom beta 2 blockade could be harmful.

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