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Intraocular Pressure Lowering Effect of Latanoprost as First-line Treatment for Glaucoma

Aspberg, Johan, MD*; Heijl, Anders, MD, PhD*; Jóhannesson, Gauti, MD, PhD†,‡; Lindén, Christina, MD, PhD; Andersson-Geimer, Sabina, MD, PhD*; Bengtsson, Boel, PhD*

doi: 10.1097/IJG.0000000000001055
Original Studies

Purpose: The purpose of this study was to assess the intraocular pressure (IOP) - reducing effect of latanoprost in treatment-naïve patients with newly detected open-angle glaucoma with no restriction of the level of untreated IOP.

Methods: Eighty-six patients (105 eyes) with a diagnosis of open-angle glaucoma received IOP-lowering therapy with latanoprost. The IOP reduction 1 and 3 months after initiation of treatment was recorded.

Results: Mean untreated IOP for all eyes was 26.2 mm Hg (ranging from 10 to 51 mm Hg). The mean pressure reduction was 7.9 mm Hg (28%), with equivalent average levels at 1 and 3 months. The reduction in IOP ranged from −2.3 to 25.3 mm Hg after 1 month, and from −1.3 to 33.3 mm Hg after 3 months. The pressure-lowering effect was considerably more pronounced in eyes with higher untreated IOP; the reduction increased by 0.55 mm Hg per mm Hg higher untreated IOP. Four eyes, with untreated IOP within statistically normal limits, had no or negative IOP-reduction. A regression model predicted that IOP reduction ended at untreated IOP≤16 mm Hg. Multiple regression analysis showed that an additional IOP-lowering effect of 1.28 mm Hg was achieved in eyes with pseudoexfoliation glaucoma.

Conclusions: To the best of our knowledge, this paper is the first to report the IOP-reducing effect of latanoprost treatment at all untreated IOP levels in newly detected glaucoma patients. The effect was proportional to the untreated IOP at all levels above 16 mm Hg and better at higher untreated IOP levels, also in relative terms. Our results further confirm the indication of latanoprost as a first-line therapy for glaucoma.

*Department of Clinical Sciences in Malmö, Ophthalmology, Lund University, Malmö

Department of Clinical Sciences, Ophthalmology

Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden

Supported by regional agreements between Lund University and Skåne Regional Council and Umeå University and Västerbotten County Council (ALF), and also by grants from Crown Princess Margareta’s Foundation, the Swedish Eye Foundation, the Swedish Medical Society Foundation, the Cronqvist Foundation, the Herman Järnhardt Foundation, the Foundation for Visually Impaired in Former Malmöhus County, Ingrid Nordmark’s Foundation, the Margit and Kjell Stolz Foundation, foundations and donations administered by Skåne University Hospital, foundations and donations administered by Umeå University Hospital, King Gustav V and Queen Victoria’s Freemason Foundation, Wallenberg Centre for Molecular Medicine, and the Swedish Society for Medical Research.

J.A.: has received speaking honoraria from Allergan. A.H.: is a consultant to Carl Zeiss Meditec and Allergan, and has received speaking honoraria from Allergan, Zeiss and Santen. G.J.: has received speaking honoraria and/or consulting fees from Topcon, Thea, Santen, Allergan, Alcon/Novartis. C.L.: has received consultant fee from Allergan and speaking honoraria from Santen Pharma. S.A.-G.: has received a travel grant from Allergan. B.B.: is a consultant to Carl Zeiss Meditec.

Reprints: Johan Aspberg, MD, Department of Clinical Science, Ophthalmology, Lund University, SE- 20502 Malmö, Sweden (e-mail: johan.aspberg@med.lu.se).

Received June 2, 2018

Accepted August 5, 2018

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