Changes in visual function after intraocular pressure reduction using antiglaucoma medications.
OBJECTIVE
To evaluate the change in visual function after starting glaucoma treatment and correlate this to a decrease in intraocular pressure (IOP) in primary open-angle glaucoma patients.


METHODS
A prospective, randomized clinical trial was carried out involving 54 glaucoma patients (54 eyes). After inclusion, patients randomly received timolol maleate 0.5%, brimonidine tartrate 0.2%, or travoprost 0.004% in one randomly selected eye. Patients underwent Goldmann applanation tonometry, visual acuity test, standard automated perimetry (SAP), visual quality perception test (visual analogue scale), and contrast sensitivity (CS) test, in a random order before and after the 4-week glaucoma treatment.


RESULTS
There were statistically significant changes in IOP (mean change [standard deviation], 7.8 [3.6] mmHg, P<0.001), SAP mean deviation index (0.84 [2.45] dB, P=0.02), visual quality perception (0.56 [1.93], P=0.045), and CS at frequencies of 12 cycles/degree (0.10 [0.37], P=0.03) and 18 cycles/degree (0.18 [0.42], P=0.02) after the 4-week treatment when compared with baseline. No statistically significant differences were found between the treatment groups in visual function changes after treatment (P>0.40). No significant correlations between IOP reduction and changes in visual function were found (P>0.30).


CONCLUSIONS
Visual quality perception, visual field mean deviation index, and CS at higher frequencies improve after starting glaucoma therapy. However, no correlation was found between IOP reduction and changes in visual function, and no differences were found in visual function when the three medications studied were compared.
Prata
T S
TS
Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil. tiagoprata@oftalmo.epm.br
Piassi
M V
MV
Melo
L A S
LA
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000068438:Brimonidine Tartrate; D003008:Cloprostenol / Q000031:analogs & derivatives / Q000627:therapeutic use; D015350:Contrast Sensitivity / Q000187:drug effects; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011810:Quinoxalines / Q000627:therapeutic use; D013999:Timolol / Q000627:therapeutic use; D000069557:Travoprost; D014792:Visual Acuity / Q000187:drug effects*; D014794:Visual Fields / Q000187:drug effects; D014796:Visual Perception / Q000187:drug effects*
D000959:Antihypertensive Agents; D011810:Quinoxalines; D003008:Cloprostenol; D000068438:Brimonidine Tartrate; D013999:Timolol; D000069557:Travoprost