COMPARISON OF THE EFFECT OF LATANOPROST 0.005-PERCENT AND TIMOLOL 0.5-PERCENT ON THE CALCULATED OCULAR PERFUSION-PRESSURE IN PATIENTS WITH NORMAL-TENSION GLAUCOMA

PURPOSE: To compare the calculated mean ocular perfusion pressure at t he end of 3 weeks' treatment with latanoprost 0.005% once daily or tim olol 0.5% twice daily in normal-tension glaucoma patients. METHODS: In a three-center, double masked, randomized, crossover study, 36 patien ts were allocated to two treatment groups; one received 3 weeks each o f placebo, latanoprost, placebo, and timolol, whereas the other group had placebo, timolol, placebo, and latanoprost. Intraocular pressure a nd resting systemic blood pressure were measured at 9 AM, 12 noon, and 4 PM. Ocular perfusion pressure was calculated for each time period a s well as the mean of three values (daytime average). Systemic blood p ressure and heart rate were also recorded at 30 minute intervals durin g the last 24 hours of each treatment period. RESULTS: The average day time mean ocular perfusion pressure (mean +/- SEM) following latanopro st treatment was 53.2 +/- 1.4 mm Hg, an increase of 8% from the latano prost run in period, compared with 50.9 +/- 1.1 mm Hg following timolo l treatment, an increase of 2% from the timolol run-in period (P < .05 , ANOVA). Timolol reduced the blood pressure. The difference in mean d aytime and nighttime systolic blood pressure measurements as well as n ighttime diastolic blood pressure was about 5 mm Hg between the latano prost and timolol treatments. The daytime and nighttime heart rates we re also slower during the timolol treatment. CONCLUSION: Because ocula r perfusion pressure may be important in some glaucomatous patients, l atanoprost appears to affect ocular per fusion pressure more favorably than timolol does in patients with normal-tension glaucoma. (C) 1998 by Elsevier Science Inc. All rights reserved.