ADDITIVE OCULAR HYPOTENSIVE EFFECT OF LATANOPROST AND ACETAZOLAMIDE -A SHORT-TERM STUDY IN PATIENTS WITH ELEVATED INTRAOCULAR-PRESSURE

Objective: To investigate the additive ocular hypotensive effect of la tanoprost on the intraocular pressure (IOP) reduction induced by a sub optimal dose of acetazolamide, a carbonic anhydrase inhibitor. Design: A short-term, randomized, placebo-controlled, double-masked study. Pa rticipants: Twenty-four patients with glaucoma with elevated IOPs. Int ervention: Acetazolamide 250 mg twice daily from day 1 to day 18. Topi cal 50 mu g/ml latanoprost or placebo eye drops bilaterally instilled once daily from day 4 to day 18. Mean Outcome Measures: IOP, conjuncti val hyperemia. Results: The mean IOP of 19.5 mmHg during acetazolamide treatment was further reduced to 16.8 mmHg after topical administrati on of latanoprost, i.e., a decrease of 2.9 +/- 2.8 mmHg (15%, P < 0.00 1). Administration of placebo to patients on acetazolamide resulted in an upward drift of 1.3 mmHg (6%, P = 0.03). A modest but statisticall y significant increase in conjunctival hyperemia was found in the lata noprost-treated group, but did not affect the masking. Conclusions: Th is short-term study indicates that the combination of topically applie d latanoprost and a suboptimal dose of systemic carbonic anhydrase inh ibitor is useful in the management of glaucoma.