Effects of glaucoma medications on the cardiorespiratory and intraocular pressure status of newly diagnosed glaucoma patients.
OBJECTIVE
To evaluate the short term cardiovascular, respiratory, and intraocular pressure (IOP) effects of four glaucoma medications in newly diagnosed glaucoma patients.


METHODS
141 newly diagnosed glaucoma patients were recruited and underwent a full ocular, cardiovascular, and respiratory examination, including an electrocardiogram (ECG) and spirometry. They were prescribed one of four topical glaucoma medications and reviewed 3 months later. One eye of each patient was randomly chosen for analysis, performed using analysis of variance and the chi(2) test.


RESULTS
Latanoprost had the greatest mean IOP lowering effect in both the primary open angle glaucoma (POAG) (p = 0.005) and the "presumed" normal tension glaucoma (NTG) groups (p = 0.33), reducing the IOP by 8.9 mm Hg and 4.1 mm Hg respectively. Timolol was associated with lowered pulse rates and reductions in the spirometry measurements. 41% of patients using brimonidine complained of systemic side effects and over 55% of patients using betaxolol complained of ocular irritation. 28% of patients required an alteration in their glaucoma management.


CONCLUSIONS
Latanoprost appears to be a useful primary treatment for glaucoma patients, in view of superior IOP control and a low incidence of local and systemic side effects. Timolol causes a reduction in measurements of respiratory function, a concern in view of the potential subclinical reversible airways disease in the elderly glaucoma population. Brimonidine is associated with substantial, unpredictable systemic side effects and betaxolol causes ocular irritation and weak IOP control. Spirometry is advised in all patients receiving topical beta blocker therapy to control their glaucoma.
Waldock
A
A
Department of Ophthalmology, Torbay Hospital, Torquay TQ2 7AA. awaldock@hotmail.com
Snape
J
J
Graham
C M
CM
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000704:Analysis of Variance; D015784:Betaxolol / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D005901:Glaucoma / Q000150:complications / Q000188:drug therapy*; D006333:Heart Failure / Q000150:complications; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008173:Lung Diseases, Obstructive / Q000150:complications; D008297:Male; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D011465:Prostaglandins, Synthetic / Q000627:therapeutic use; D011674:Pulse; D013999:Timolol / Q000627:therapeutic use; D014797:Vital Capacity / Q000187:drug effects
D000316:Adrenergic alpha-Agonists; D000319:Adrenergic beta-Antagonists; D009883:Ophthalmic Solutions; D011465:Prostaglandins, Synthetic; D013999:Timolol; D015784:Betaxolol