Changes in glaucoma treatment and achieved IOP after introduction of new glaucoma medication.
OBJECTIVE
To describe changes in glaucoma treatment and achieved IOP (intraocular pressure) over the period 1995-2002, 4 years before and 4 years after new glaucoma drugs had become available (January 1999).


METHODS
An observational study was conducted in primary open-angle glaucoma (suspect), and ocular hypertension patients (n=1561) who had started medical treatment in 1995 or thereafter. The processes of starting, changing and intensifying medical treatment in general, and in patients with contraindications to beta-blockers before and after January 1999 were described. The change in mean IOP and the percentage of patients achieving an intraocular pressure below 18 or 22 mmHg were calculated.


RESULTS
After January 1999, a shift from starting on betaxolol to hypotensive lipids took place. This shift was more pronounced in patients with respiratory comorbidity. The percentage of patients starting on timolol did not differ between both periods. After January 1999, therapy was changed more often in the first two visits compared with the period before January 1999 (38% versus 27%, P<0.0001). In more recent years, a larger percentage of glaucoma patients were treated with two or more drugs (34% in 2002 versus 13% in 1995). Over the period 1995-2002, baseline IOP did not change (P=0.85); for mean IOP at visit 4, a trend to lower IOPs was observed (P<0.0001). More patients achieved an IOP level under 22 and 18 mmHg after January 1999 than before, 85% versus 77%, and 46% versus 33%, respectively (P<0.0001).


CONCLUSIONS
This study shows a change in process of glaucoma treatment and lower achieved IOP after new glaucoma drugs had become available.
Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
Rikkert
R
van der Valk
Jan S A G
JS
Schouten
Carroll A B
CA
Webers
Fred
F
Hendrikse
Martin H
MH
Prins
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects* / Q000502:physiology; D008055:Lipids / Q000627:therapeutic use; D008297:Male; D009798:Ocular Hypertension / Q000188:drug therapy / Q000503:physiopathology; D011461:Prostaglandins F, Synthetic / Q000627:therapeutic use; D014065:Tonometry, Ocular
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D008055:Lipids; D011461:Prostaglandins F, Synthetic