A comparison of 0.1% timolol eye gel and 0.5% timolol eye drop in patients with chronic angle-closure glaucoma.
BACKGROUND
Primary angle-closure glaucoma has been reported with higher prevalence in Asian populations. There is no significant data of different response of topical medication between angle- closure and open angle eyes.


OBJECTIVE
The present study investigates ocular hypotensive effect and systemic side effects of 0.1% timolol eye gel once daily compared with 0.5% timolol eye drop twice daily in patients with chronic angle-closure glaucoma.


METHODS
The present study was a prospective, randomized, investigator-masked, two-period crossover study in chronic angle-closure glaucoma patients with each drug tested for a six-week period.


RESULTS
Twenty five eyes were included. Timolol 0.1% eye gel and 0.5% timolol eye drop significantly reduced IOP at 9 am, 11 am and 3 pm compared with baseline (P < 0.001). At week 6, the mean IOP reduction from baseline of 0.5% timolol eye drop group was higher than that of 0.1% timolol eye gel group at 9 am (3.68 mmHg, 2.51 mmHg respectively) and at 11 am (4.21 mmHg, 2.51 mmHg respectively). These differences were not statistically significant (p = 0.421, p = 0.157 respectively). At 3 pm of week 6, the mean IOP change from baseline of 0.1% timolol eye gel group (3.03 mmHg) was more than that of 0.5% timolol eye drop group (2.84 mmHg). There was also statistically insignificant difference (p = 0.873). The highest IOP reduction of 0.5% timolol eye drop was 4.21 mmHg (19.82%) at 11 am of week 6 and that of 0.1% timolol eye gel was 3.03 mmHg (14.38%) at 3 pm of the same week. There was no significant ocular side effect. Systolic blood pressure after treatment with 0.1% timolol eye gel and diastolic blood pressure after treatment with 0.5% timolol eye drop were significantly decreased from baseline (P = 0.006 and P = 0.026 respectively). But there was no clinical significance.


CONCLUSIONS
Timolol 0.5% eye drop and 0.1% timolol eye gel effectively reduced IOP in chronic angle-closure glaucoma patients. There was no statistically significant difference in the ocular hypotensive effect of both drugs over a 24-hour period. There was no ocular side effect. Systemic side effect was clinically insignificant difference in both groups.
Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Ankana
A
Metheetrairut
Panitee
P
Leumsamran
Supamas
S
Rojananin
Naris
N
Kitnarong
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D005782:Gels; D015812:Glaucoma, Angle-Closure / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D013999:Timolol / Q000008:administration & dosage*; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D005782:Gels; D009883:Ophthalmic Solutions; D013999:Timolol