title: Asymmetry of 24-hour intraocular pressure reduction by topical ocular hypotensive medications in fellow eyes.
abstract: OBJECTIVE
  A core assumption for the 1-eye therapeutic trial of ocular hypotensive medications is the symmetrical reduction of intraocular pressure (IOP) in paired eyes. This assumption was evaluated for 24-hour IOP reduction in patients who underwent monotherapy or adjunctive therapy.
  
  
  METHODS
  Database study.
  
  
  METHODS
  Patients 41 to 79 years of age with primary open-angle glaucoma or ocular hypertension.
  
  
  METHODS
  Twenty-four-hour IOP data from the paired eyes of patients undergoing bilateral monotherapy (n = 66) of latanoprost, travoprost, timolol, or brimonidine or bilateral adjunctive therapy (n = 52) with brinzolamide or timolol added to latanoprost monotherapy were analyzed retrospectively. Measurements of IOP were obtained every 2 hours in a sleep laboratory before and after at least 4-week drug treatments. Strengths of association for single-pair IOP reductions and average IOP reductions in the paired eyes during the office-hour, diurnal, nocturnal, and 24-hour periods and in different body positions were analyzed.
  
  
  METHODS
  Variance for the difference, percentage distribution of large absolute difference, and coefficient of determination (r(2)) in the paired IOP reductions.
  
  
  RESULTS
  The standard deviations for the differences in single-pair IOP reductions from the means were larger than 2.5 mmHg for all periods and body positions under monotherapy and adjunctive therapy. Absolute differences in single-pair IOP reductions of the cutoff thresholds of 3 and 2 mmHg or more occurred in more than 20% and 36% cases, respectively. Corresponding coefficients of determination were 0.240 to 0.374 with monotherapy and 0.215 to 0.381 with adjunctive therapy. When the average differences in the paired IOP reductions were analyzed for a specific period and posture, the standard deviations for the differences in the paired IOP reductions and the percentage distributions of large absolute differences were reduced, and most coefficients of determination were improved.
  
  
  CONCLUSIONS
  There is only a weak association between the right- and left-eye responses to IOP-lowering monotherapy or adjunctive therapy during a 24-hour period when single-pair IOP data are considered. Considering the averages of multiple paired IOP responses can improve the strength of the association.
  
  
  BACKGROUND
  The author(s) have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA. joliu@ucsd.edu
authors.forename: John H K
authors.initials: JH
authors.lastname: Liu
authors.forename: Tony
authors.initials: T
authors.lastname: Realini
authors.forename: Robert N
authors.initials: RN
authors.lastname: Weinreb
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D000068438:Brimonidine Tartrate; D002940:Circadian Rhythm / Q000502:physiology*; D003008:Cloprostenol / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D000077338:Latanoprost; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy / Q000503:physiopathology; D011187:Posture; D011461:Prostaglandins F, Synthetic / Q000008:administration & dosage; D011810:Quinoxalines / Q000008:administration & dosage; D012189:Retrospective Studies; D013449:Sulfonamides / Q000008:administration & dosage; D013843:Thiazines / Q000008:administration & dosage; D013999:Timolol / Q000008:administration & dosage; D014065:Tonometry, Ocular; D000069557:Travoprost
chemical_list: D000959:Antihypertensive Agents; D011461:Prostaglandins F, Synthetic; D011810:Quinoxalines; D013449:Sulfonamides; D013843:Thiazines; D003008:Cloprostenol; D000068438:Brimonidine Tartrate; D000077338:Latanoprost; D013999:Timolol; C111827:brinzolamide; D000069557:Travoprost