Effects of glaucoma medications on the cardiorespiratory and intraocular pressure status of newly diagnosed glaucoma patients

Aims-To evaluate the short term cardiovascular, respiratory, and intraocula r pressure (IOP) effects of four glaucoma medications in newly diagnosed gl aucoma patients. Methods-141 newly diagnosed glaucoma patients were recruited and underwent a full ocular, cardiovascular, and respiratory examination, including an el ectrocardiogram (ECG) and spirometry. They were prescribed one of four topi cal glaucoma medications and reviewed 3 months later. One eye of each patie nt was randomly chosen for analysis, performed using analysis of variance a nd the chi(2) test Results-Latanoprost had the greatest mean IOP lowering effect in both the p rimary open angle glaucoma (POAG) (p = 0.005) and the "presumed" normal ten sion glaucoma (NTG) groups (p = 0.33), reducing the IOP by 8.9 nun Hg and 4 .1 mm Hg respectively. Timolol was associated with lowered pulse rates and reductions in the spirometry measurements. 41% of patients using brimonidin e complained of systemic side effects and over 55% of patients using betaxo lol complained of ocular irritation. 28% of patients required an alteration in their glaucoma management. Conclusions-Latanoprost appears to be a useful primary treatment for glauco ma patients, in view of superior IOP control and a low incidence of local a nd systemic side effects. Timolol causes a reduction in measurements of res piratory function, a concern in view of the potential subclinical reversibl e airways disease in the elderly glaucoma population. Brimonidine is associ ated with substantial, unpredictable systemic side effects and betaxolol ca uses ocular irritation and weak IOP control. Spirometry is advised in all p atients receiving topical p blocker therapy to control their glaucoma.