Abstract
Objectives: Retrospective study to compare long-term effects of treatment with β-blockers and prostaglandins by assessing changes in visual fields. Methods and Patients: The group included 60 patients of approximately the same age (61 and 62 year olds), with the same changes in the visual field and the same central corneal thickness (556 μm), of which 30 were treated with β-blockers (18 females and 12 males) and 30 with prostaglandins (15 females and 15 males). There were no changes in medication in the course of treatment. During the follow-ups, the intraocular pressure was in the range 10 to 20 mmHg. We evaluated the changes in visual fields (pattern defects) at the last examination in 2012. The results were compared with findings in visual fields from 2005. No subject had any eye or systemic disease that could affect changes in the visual field. Corneal pachymetry was performed with a Tomey SP-100 ultrasound device. The visual field was examined by static perimetry using a MEDMONT M 700 device with a fast threshold glaucoma program. For comparison of the two groups treated with β-blockers and prostaglandins, we used the Mann-Whitney´s test. For comparison of treatment with β-blockers timolol, carteolol, betaxozol and vistagan, we used the non-parametric Kruskal-Wallis´ test, and subsequently to compare therapies with prostaglandins latanoprost and bimatoprost, we used the non-parametric two-sided Mann-Whitney´s test. Results: With statistical analysis, we have found neither changes between β-blockers and prostaglandins treatments (p=0.395 to 0.836) nor differences between different beta-blockers (p=0.495 to 0.576). Similarly, we found no statistically significant changes in either treatment with bimatoprost and latanoprost (0.575 to 0.965). Conclusion: Our results in the follow-up period of seven years showed no difference in the functional changing of visual field between the treatments with β-blockers and prostaglandins.
Highlights
Glaucoma is a progressive neurodegenerative disease of retinal ganglion cells (RGCs) associated with characteristic axon degeneration in the optic nerve [1]
Our results in the follow-up period of seven years showed no difference in the functional changing of visual field between the treatments with β-blockers and prostaglandins
Timolol binds to voltage-gated calcium and sodium channels, which in turn reduces NMDA stimulated calcium influx, to a much lower affinity in comparison to betaxolol
Summary
Glaucoma is a progressive neurodegenerative disease of retinal ganglion cells (RGCs) associated with characteristic axon degeneration in the optic nerve [1]. NMDA and glutamate affinity is reduced, further reducing calcium influx into the RGCs. Timolol binds to voltage-gated calcium and sodium channels, which in turn reduces NMDA stimulated calcium influx, to a much lower affinity in comparison to betaxolol. High doses of timolol are required to be absorbed systemically. For this reason, the topical route may have a better efficacy in reducing IOP and RGC loss through absorption of timolol into systemic circulation, which plays an vital role [7]
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