PSS1 - A Prospective Study to Compare Safety and Efficacy of Various Anti-Glaucoma Agents and Evaluate the Effect of Aerobic Exercise on Intra-Ocular Pressure in Newly Diagnosed Primary Open Angle Glaucoma Patients in a Tertiary Care Hospital

Abstract

To evaluate safety and efficacy of Timolol and Brimolol (Brimonidine+Timolol) and study effect of aerobic exercise on intra ocular tension (IOT) in timolol treated patients. A prospective study including 90 cases of newly diagnosed primary open angle glaucoma (POAG) from ophthalmology inpatients divided into 3 groups: 1-Timolol, 2-Timolol (Exercise) and 3-Brimolol.Each patient was administered with topical drugs followed up every 15th day. Efficacy of drugs were tested based on IOT measurement by Non-contact tonometer at an interval of 15 days and safety on the basis of ADR check list, fundoscopy and slit lamp examination with tear film break up time and tear gland secretion (schirmer test).In group 2, patients were advised to do 30 min exercise daily for 1 month. Mean reduction in IOT was statistically significant with values as 2.7, 5& 7.9 mmHg and 6, 9&11 mmHg in group 1, 2 and 3 at 15th and 30th day. Frequency of ADR in group 1, 2&3 was 36%, 30% &40% respectively with the most frequent ADR in group 1&2 as burning of eyes (50%) & in group 3 as dryness (22%).Effect of brimolol on schirmer test was significant with a mean difference of 4.33 mmHg. Frequency of patients missing ophthalmic doses were 60%, 48% &48% and drop out treatment rate was 9%,9%& 14% in group 1, 2& 3 respectively with monetary reason (most common).Most frequent cause of missing ophthalmic doses was ADR (30%) in group 1&2 and monetary reason (43%) in group 3(predominantly in lower class).GQR-15 score was 35, 29&30.5 in group 1, 2 &3. Brimolol provides superior IOT lowering to timolol but is less well tolerated.Exercise along with timolol provides superior IOT lowering effect to timolol alone & is better tolerated, has superior visual QOL with reduced frequency of missed ophthalmic doses.Brimolol substantially reduces tear gland secretion.