Effect of timolol 0.5% gel and solution on pulmonary function in older glaucoma patients

Purpose: To evaluate the effect of timolol maleate solution or gel forming solution versus placebo on pulmonary function in patients with primary open -angle glaucoma or ocular hypertension without reactive airway disease. Methods: After a screening visit, each patient was randomized by a Latin sq uare technique to receive placebo twice daily, 0.5% timolol solution twice daily, or 0.5% timolol gel once a day (placebo given as second dose) to eac h eye for 2 weeks. Subjects then were crossed over to the two other treatme nts for 2-week treatment intervals. At each visit, patients were received a dose 15 minutes before pulmonary function testing. Results: This study began with 25 patients, and 20 finished the trial. Ther e was no difference between treatment groups for the forced expiratory volu me at one second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio (P > 0 .1). The mean FEV1 for timolol solution, timolol gel, and placebo was 2.42 L, 2.45 L, and 2.50 L, respectively. The mean FVC for timolol solution, tim olol gel, and placebo was 3.33 L, 3.38 L, and 3.44 L, respectively. No diff erence in intraocular pressure was observed between the timolol solution (1 7.1 +/- 3.3 mm Hg) and timolol gel (17.1 +/- 3.6 mm Hg) between the treatme nt periods (P > 0.1). No difference in side effects was observed between tr eatment groups (P > 0.05). Conclusions: In older patients with primary open-angle glaucoma or ocular h ypertension without reactive airway disease, nonselective beta -blockers sh ould not worsen pulmonary function.