Meta-analysis of timolol on diurnal and nighttime intraocular pressure and blood pressure.
OBJECTIVE
To evaluate the nighttime intraocular pressure (IOP) and blood pressure (BP) response to timolol treatment in patients with ocular hypertension or primary open-angle glaucoma.


METHODS
This was a meta-analysis of previously published studies that must have been randomized, prospective, crossover or parallel, single or double-masked trials. The treatment period must have been ≥2 weeks with ≥19 patients per treatment arm for a crossover, and ≥50 patients for a parallel designed trial. Studies must have included both baseline and treated 24-hour curves.


RESULTS
For the IOP analysis, we included 8 articles with 340 patients. A reduction from baseline was observed for timolol at each time point and for the 24-hour curve (p≤0.009). When 2 studies, in which timolol was used adjunctively, were removed, a similar difference was observed as above at each time point and for the 24-hour curve (p≤0.003). In 2 studies, there were small reductions from baseline for the mean diastolic and systolic BPs at most time points and for the 24-hour curve (3.9 and 4.2 mmHg, respectively) with timolol treatment. The ocular perfusion pressure did not show any difference between baseline and timolol treatment at any time point or for the 24-hour curve (p>0.05).


CONCLUSIONS
This meta-analysis suggests that topical timolol therapy provides an ocular hypotensive effect over the 24-hour curve, including the nighttime hours, and while small reductions in the systolic and diastolic pressures occur, the ocular perfusion pressure is not altered over 24 hours.
Lee
Princeton Wen-Yuan
PW
Royal Victoria Eye and Ear Hospital, Dublin, Ireland.
Doyle
Aoife
A
Stewart
Jeanette A
JA
Kristoffersen
Caroline J
CJ
Stewart
William C
WC
D000287:Administration, Topical; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D002940:Circadian Rhythm / Q000187:drug effects* / Q000502:physiology; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects* / Q000502:physiology; D009798:Ocular Hypertension / Q000188:drug therapy / Q000503:physiopathology; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D013999:Timolol / Q000008:administration & dosage*; D014065:Tonometry, Ocular
D000319:Adrenergic beta-Antagonists; D009883:Ophthalmic Solutions; D013999:Timolol