24-hour intraocular pressure in glaucoma patients randomized to receive dorzolamide or brinzolamide in combination with latanoprost

Abstract

Purpose: To investigate the efficacy of dorzolamide 1% (bid or tid) or brinzolamide 1% bid on 24-hour intraocular pressure (IOP) control as well as patients' preference for either drug when added in combination with latanoprost against glaucoma (IOP, >/=18 mmHg).

Methods: In this randomized crossover study patients were assigned to receive latanoprost plus either dorzolamide or brinzolamide for four weeks. Thereafter, patients underwent 24-hour IOP monitoring while continuing to receive dorzolamide (for two successive days/nights: at first bid then tid) or brinzolamide bid (once overnight). They were then switched over to receive the other test medication for a further four weeks and subsequently reexamined for 24-hour IOP. A questionnaire survey on treatment satisfaction was performed.

Results: In 20 patients dorzolamide bid or tid or brinzolamide bid exerted significant (p < 0.001) reductions of IOP from baseline at all time-points over 24 hours; no difference was detected among the treatment regimens. Significantly (p < 0.05) more patients preferred dorzolamide (n = 9) over brinzolamide (n = 2), whereas nine patients gave a neutral answer.

Conclusion: Dorzolamide bid or tid and brinzolamide bid when combined with latanoprost therapy elicited significant IOP reduction for 24 hours. It is rational to consider patients' preference of therapeutic regimen especially long-term users such as those with glaucoma.

Keywords: 24-hour intraocular pressure (IOP); brinzolamide; dorzolamide; glaucoma; latanoprost combination therapy; questionnaire survey.

Figure 1

Twenty-four-hour change of intraocular pressure (IOP) in the three treatment groups. Notes: □, Dorzolamide bid (n = 20); ○, brinzolamide bid (n = 20); •, dorzolamide tid (n = 17). Significant reduction of IOP from baseline was noted in all 3 treatment groups at all measurement time-points (paired t-test).

Figure 2

Percent additional intraocular pressure (IOP) reduction during the day and at night. No significant difference of daytime and nighttime mean percent additional IOP reduction was noted among the three treatment groups as determined by analysis of variance.

Figure 3

Ocular discomfort and adverse events and their duration under treatment with each carbonic anhydrase inhibitor.