Intraocular pressure control over 24 hours using travoprost and timolol fixed combination administered in the morning or evening in primary open-angle and exfoliative glaucoma.
OBJECTIVE
To evaluate intraocular pressure (IOP) control over 24 hours using travoprost and timolol fixed combination (TTFC) administered in the morning or evening in primary open-angle and exfoliative glaucoma.


METHODS
Patients were randomized to TTFC administered in either the morning or evening for 8 weeks. Previously treated patients underwent an untreated washout period of 4-6 weeks, after which baseline IOP was required to be > 25 mm Hg and < 38 mmHg (in two readings taken at 10.00 +/- 1 hours). During the treatment period, IOP was measured at 10.00, 14.00, 18.00, 22.00, 02.00 and 06.00 hours. Patients were then treated with the opposite dosing regimen for 8 weeks and IOP measurements were repeated.


RESULTS
In 32 subjects who completed the study, the untreated baseline IOP following washout was 27.7 +/- 3.5 mmHg. Both dosing regimens reduced IOP from baseline at each time-point and throughout the 24-hour diurnal curve (p < 0.0001). When treatments were compared directly, evening dosing (18.4 +/- 3.3 mmHg) provided a statistically significant lower 24-hour curve than morning dosing (19.2 +/- 3.5 mmHg; p = 0.001). Evening dosing also resulted in a lower 24-hour IOP fluctuation (3.8 +/- 1.6 mmHg) than morning dosing (5.1 +/- 1.6 mmHg; p = 0.0002) and lower peak IOP (p = 0.0003).


CONCLUSIONS
Both morning and evening administration of TTFC provide effective 24-hour IOP reduction, but evening dosing demonstrates better 24-hour pressure control.
Konstas
Anastasios G P
AG
First University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece.
Tsironi
Sevasti
S
Vakalis
Athanasios N
AN
Nasr
Mayssa B
MB
Stewart
Jeanette A
JA
Nelson
Lindsay A
LA
Stewart
William C
WC
D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002940:Circadian Rhythm; D003008:Cloprostenol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004338:Drug Combinations; D017889:Exfoliation Syndrome / Q000188:drug therapy* / Q000503:physiopathology; 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; D013999:Timolol / Q000008:administration & dosage* / Q000009:adverse effects; D014065:Tonometry, Ocular; D000069557:Travoprost; D014792:Visual Acuity
D000959:Antihypertensive Agents; D004338:Drug Combinations; D003008:Cloprostenol; D013999:Timolol; D000069557:Travoprost