Impact of tafluprost and tafluprost/timolol on the thickness of the retina in the macular area

Abstract

Prostaglandinanalogues (PAs) are the drugs of choice in the treatment of primary open-angle glaucoma (POAG). However, they have pro-inflammatory properties and may cause macular edema. Tafluprost is the first PA to be free of preservatives. The efficacy and safety of tafluprost, as well as that of tafluprost/timolol fixed combination (FC), was demonstrated in randomized multicenter trials. However, there are no literary data concerning the effect of tafluprost and its FC on the thickness of the macula.Purpose. To assess the effect of tafluprost and tafloprost/timolol on the retinal thickness in the macular area in patients with POAG.Material and methods. The retinal thickness (RT) was measured with an interval of a week in 36 patients (36 eyes) with a newly diagnosed initial stage of POAG, 12 of whom were prescribed taflotan, 12 patients received tafluprost/timolol FC, and 12 eyes represented the control group (no drugs were prescribed). The measurements were performed in the macular area using a spectral domain optical coherence tomography (SD-OCT) by means of the RtVue xR Avanti with the AngioVue OCT angiography function. The change in the intraocular pressure (IOP) and RT from the inner limiting membrane (ILM) to the inner plexiform layer (inner retina) and to the pigment epithelium (PE) in fovea and parafovea in total and by sectors were estimated by comparing paired repeated observations using the median growth analysis.Results. In the tafluprost group, a 19.4 % IOP decrease was revealed and in the tafluprost/timolol group the decrease achieved 43 % with respect to the reference level. In patients receiving tafluprost, an increase in the RT in parafovea was noted: median growth 2 μm (p = 0.035); and in patients receiving tafluprost/timolol — in the inner layers of parafovea: median growth 3 μm (p = 0.031), and its inferior half: median growth 2.5 μm (p = 0.023). These changes were obtained in 10 patients out of 12 in each treated group. In untreated patients, the RT remained unchanged. The visual acuity did not change in any group of patients.Conclusions. In patients with glaucoma, a thickening of both the inner layers and the entire macular retina occurred within a week after treating with tafluprost or its FC, leaving no clinical manifestation. This fact should be taken into account in patients likely to develop macular edema.