CIRCADIAN INTRAOCULAR-PRESSURE MANAGEMENT WITH LATANOPROST - DIURNAL AND NOCTURNAL INTRAOCULAR-PRESSURE REDUCTION AND INCREASED UVEOSCLERALOUTFLOW

Based on their mechanism of action, the most frequently used ocular hy pertensive agents, the beta-blockers, cannot be assumed to reduce IOP during sleep. The need for drugs that reduce IOP around-the-clock is u nderscored, however, by the fact that inadequate nocturnal ocular perf usion pressure is considered to be one of the likely causes of glaucom atous optic neuropathy especially in some cases of normal tension glau coma. The studies reviewed here demonstrate that latanoprost, a new oc ular hypotensive prostaglandin F-2 alpha analogue, applied once a day at a concentration of 0.005%, maintains a statistically highly signifi cant IOP reduction around-the-clock. The magnitude of this IOP reducti on was found to be essentially identical during the day and at night, both in patients maintained on timolol and in those not receiving othe r glaucoma medication. Latanoprost-induced IOP reduction was also foun d to he associated. with increased uveoscleral outflow in normotensive volunteers, both during the day and at night. These circadian studies suggest that this new ocular hypotensive agent can be expected to be particularly useful for the medical management of some forms of glauco ma, such as normal tension glaucoma, when the cause of the glaucomatou s damage cannot be linked specifically to diurnal IOP abnormalities.