COMPARISON OF LATANOPROST AND TIMOLOL IN PATIENTS WITH OCULAR HYPERTENSION AND GLAUCOMA - A 6-MONTH, MASKED, MULTICENTER TRIAL IN THE UNITED-STATES

Purpose: Latanoprost, a new prostaglandin analogue, was compared with timolol for ocular hypotensive efficacy and side effects. Methods: In a multicenter, randomized, double-masked, parallel group study, 268 pa tients with ocular hypertension or early primary open-angle glaucoma r eceived either 0.005% latanoprost once daily or 0.5% timolol twice dai ly for 6 months. All except ten patients from each group successfully completed the study.Results: Intraocular pressure (IOP) was significan tly (P ( 0.001) reduced and maintained by both medications without evi dence of a long-term drift over 6 months. Comparing 6-month with basel ine diurnal IOP values, the IOP reduction (mean +/- standard deviation ) achieved with latanoprost (-6.7 +/- 3.4 mmHg) was significantly (P < 0.001) greater than that produced with timolol (-4.9 +/- 2.9 mmHg). F our patients treated with timolol and none treated with latanoprost we re withdrawn from the study because of inadequate IOP control. Pulse r ate was significantly reduced with timolol, but not with latanoprost. Slightly more conjunctival hyperemia appeared in latanoprost-treated c ompared with timolol-treated eyes. Fewer subjective side effects occur red in latanoprost-treated eyes. Both eyes of a patient with a charact eristic, concentric iris heterochromia (darker centrally) at baseline showed a definite, photographically documented increase in pigmentatio n during latanoprost treatment, making the irides uniformly darker. Th ree additional patients treated with latanoprost were suspects for thi s color change. Otherwise, no significant difference between treatment groups occurred in visual acuity, slit-lamp examination, blood pressu re, and laboratory values. Conclusion: Latanoprost has the potential f or becoming a new first-line treatment for glaucoma.