Comparison of the effects of brimonidine 0.2% and timolol 0.5% on retinal nerve fiber layer thickness in ocular hypertensive patients: a prospective, unmasked study.
OBJECTIVE
The aim of this study was to compare the effects of brimonidine and timolol on retinal nerve fiber layer (RNFL) thickness in ocular hypertensive patients.


METHODS
This was a prospective, comparative, and unmasked study. For 12 months, 38 eyes of 19 patients with primary open-angle glaucoma received brimonidine tartrate 0.2%, and 40 eyes of 20 patients received timolol maleate 0.5%. Intraocular pressure (IOP) was measured every 2 months, and RNFL thickness was assessed using Scanning laser polarimetry (GDx) at baseline and at 12 months.


RESULTS
Mean IOP reduction was similar in both groups. Within each treatment group, the RNFL thickness for ellipse average (P = 0.004), superior (P = 0.035), temporal (P = 0.003), inferior (P < 0.0001), and nasal averages (P = 0.044) were significantly decreased from baseline in timolol at 12 months. However, the RNFL thickness for ellipse average and four quadrants showed no significant change from baseline in brimonidine. The between-group difference in RNFL change showed a significant reduction for ellipse average (P = 0.02), temporal (P = 0.005), and inferior averages (P = 0.016) following timolol therapy, as compared to brimonidine.


CONCLUSIONS
There appear to be less progression for RNFL damage following brimonidine 0.2% therapy compared to timolol 0.5% in ocular hypertensive patients over 1 year. This finding does not correlate with IOP reduction.
Tsai
Jen-Chia
JC
Department of Ophthalmology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China. tsai4118@ms26.hinet.net
Chang
Hsueh-Wen
HW
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000068438:Brimonidine Tartrate; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007322:Instillation, Drug; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000187:drug effects* / Q000473:pathology; D009883:Ophthalmic Solutions; D011446:Prospective Studies; D011810:Quinoxalines / Q000008:administration & dosage / Q000627:therapeutic use*; D012160:Retina / Q000187:drug effects* / Q000473:pathology; D013997:Time Factors; D013999:Timolol / Q000008:administration & dosage / Q000627:therapeutic use*
D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions; D011810:Quinoxalines; D000068438:Brimonidine Tartrate; D013999:Timolol