Contralateral effect of topical beta-adrenergic antagonists in initial one-eyed trials in the ocular hypertension treatment study.
OBJECTIVE
To evaluate the magnitude of the contralateral effect of topically administered beta-blockers on intraocular pressure.


METHODS
The Ocular Hypertension Treatment Study enrolled 1,636 subjects. Of these, 817 subjects were randomized to receive topical ocular hypotensive medication and 819 subjects were randomized to close observation (i.e., no topical medication). We compared the intraocular pressure of the contralateral eye of subjects at the baseline visit and after an initial one-eyed therapeutic trial of topical beta-blockers. We examined differences between baseline and follow-up intraocular pressure in untreated eyes of subjects randomized to close observation.


RESULTS
The mean reduction in intraocular pressure in the beta-blocker-treated eyes was -5.9 +/- 3. 4 mm Hg (-22% +/- 12%; Student t test, P <.0001). In the contralateral eyes, mean intraocular pressure reduction was -1.5 +/- 3.0 mm Hg (-5.8% +/- 12%; P <.0001). Of the contralateral eyes, 35% showed a reduction of 3 mm Hg or more, and 10% showed a reduction of 6 mm Hg or more. The contralateral effect of the relatively selective beta-blocker betaxolol did not differ from that of any of the nonselective beta-blockers. Factors associated with the magnitude of the contralateral effect were the degree of intraocular pressure reduction in the treated eye and baseline intraocular pressure of the contralateral eye. In the close observation group, no significant reduction in intraocular pressure was noted between the baseline and follow-up visit.


CONCLUSIONS
The contralateral effect is important in clinical practice and in clinical trials when the hypotensive effect of a topical beta-blocker is evaluated by means of a one-eyed therapeutic trial.
Piltz
J
J
Department of Ophthalmology, Scheie Eye Institute/University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Gross
R
R
Shin
D H
DH
Beiser
J A
JA
Dorr
D A
DA
Kass
M A
MA
Gordon
M O
MO
D000287:Administration, Topical; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D005260:Female; D005901:Glaucoma / Q000517:prevention & control; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy*; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D009900:Optic Nerve / Q000187:drug effects; D014786:Vision Disorders / Q000517:prevention & control; D014792:Visual Acuity; D014794:Visual Fields / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D009883:Ophthalmic Solutions