Meta-analysis of medical intervention for normal tension glaucoma.
OBJECTIVE
To evaluate the intraocular pressure (IOP) reduction achieved by the most frequently prescribed antiglaucoma drugs in patients with normal tension glaucoma (NTG).


METHODS
Systematic review and meta-analysis.


METHODS
Fifteen randomized clinical trials reported 25 arms for peak IOP reduction, 16 arms for trough IOP reduction, and 13 arms for diurnal curve IOP reduction.


METHODS
Pertinent publications were identified through systematic searches of PubMed, EMBASE, and the Cochrane Controlled Trials Register. The patients had to be diagnosed as having NTG. Methodological quality was assessed by the Delphi list on a scale from 0 to 18. The pooled 1-month IOP-lowering effects were calculated using the 2-step DerSimonian and Laird estimate method of the random effects model.


METHODS
Absolute and relative reductions in IOP from baseline for peak and trough moments.


RESULTS
Quality scores of included studies were generally high, with a mean quality score of 12.7 (range, 9-16). Relative IOP reductions were peak, 15% (12%-18%), and trough, 18% (8%-27%) for timolol; peak, 14% (8%-19%), and trough, 12% (-7% to 31%) for dorzolamide; peak, 24% (17%-31%), and trough, 11% (7%-14%) for brimonidine; peak, 20% (17%-24%), and trough, 20% (18%-23%) for latanoprost; peak, 21% (16%-25%), and trough, 18% (14%-22%) for bimatoprost. The differences in absolute IOP reductions between prostaglandin analogues and timolol varied from 0.9 to 1.0 mmHg at peak and -0.1 to 0.2 mmHg at trough.


CONCLUSIONS
Latanoprost, bimatoprost, and timolol are the most effective IOP-lowering agents in patients with NTG.
Cheng
Jin-Wei
JW
Department of Ophthalmology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China. ruiliwei@gmail.com
Cai
Ji-Ping
JP
Wei
Rui-Li
RL
D000368:Aged; D000577:Amides / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015784:Betaxolol / Q000627:therapeutic use; D000069580:Bimatoprost; D000068438:Brimonidine Tartrate; D003008:Cloprostenol / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D000077338:Latanoprost; D008297:Male; D008875:Middle Aged; D011461:Prostaglandins F, Synthetic / Q000627:therapeutic use; D011810:Quinoxalines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013449:Sulfonamides / Q000627:therapeutic use; D013843:Thiazines / Q000627:therapeutic use; D013876:Thiophenes / Q000627:therapeutic use; D013999:Timolol / Q000627:therapeutic use; D014065:Tonometry, Ocular; D000069557:Travoprost
D000577:Amides; D000959:Antihypertensive Agents; D011461:Prostaglandins F, Synthetic; D011810:Quinoxalines; D013449:Sulfonamides; D013843:Thiazines; D013876:Thiophenes; D003008:Cloprostenol; D000068438:Brimonidine Tartrate; D000077338:Latanoprost; D013999:Timolol; C111827:brinzolamide; C062765:dorzolamide; D015784:Betaxolol; D000069580:Bimatoprost; D000069557:Travoprost