Prescribing pattern and adverse events of drugs used in patients with primary open-angle glaucoma (POAG) attending a tertiary care hospital: Retrospective study

Author(s):  
Seema Rai ◽  
Seemee Khilji ◽  
Lavanya Rao ◽  
Puneet Hegde ◽  
Sarita Gonsalves ◽  
...  
2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Erum Shahid ◽  
Uzma Fasih ◽  
Arshad Shaikh

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.


2020 ◽  
Vol 22 (4) ◽  
pp. 203-210
Author(s):  
Pranisha Singh ◽  
AP Rijal

The purpose of this study was to evaluate the location and pattern of visual field defects as measured by Humphrey Field Analyzer (HFA 24-2) in newly diagnosed primary open angle glaucoma (POAG) attending tertiary care hospital. This was a cross sectional, descriptive study. One hundred and four eyes of 52 patients who fulfilled the inclusion criteria during one year were included. They were classified as mild, moderate and severe glaucoma according to severity. Paracentral scotoma in superotemporal and superonasal region was the most frequent visual field defect observed in mild glaucoma. Superior arcuate defect and double arcuate defect was commonly seen among moderate and severe stages of POAG respectively. There was a significant association between severity of glaucoma and pattern of visual field defect (p=0.000). The superior hemifield was affected twice more than the inferior hemifield in newly diagnosed cases of POAG.


Author(s):  
Aditi Maitra ◽  
Shashwat Bhattacharyya ◽  
Shatavisha Mukherjee ◽  
Nikhil Era ◽  
Sambuddha Ghosh ◽  
...  

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.


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