Ocular surface evaluation in patients treated with a fixed combination of prostaglandin analogues with 0.5% timolol maleate topical monotherapy: a randomized clinical trial

Authors

  • Heloisa Helena Russ Federal University of Sao Paulo; CASO-Ocular Surface Advanced Center
  • Pedro Antonio Nogueira-Filho Brasilia Base Hospital; Glaucoma Department
  • Jeison de Nadai Barros Brasilia Base Hospital; Glaucoma Department
  • Nubia Vanessa Lima de Faria Brasilia Base Hospital; Glaucoma Department
  • Fabiano Montiani-Ferreira Federal University of Parana; Veterinary Department
  • Jose Alvaro Pereira Gomes Brasilia Base Hospital; Glaucoma Department
  • Paulo Augusto Arruda Mello Federal University of Sao Paulo; Ophthalmology

DOI:

https://doi.org/10.1590/clin.v68i10.77008

Abstract

OBJECTIVES: To compare ocular surface changes induced via glaucoma treatment in patients using fixed combinations of prostaglandin analogues (travoprost, latanoprost and bimatoprost) with 0.5% timolol maleate METHODS: A prospective, multicenter, randomized, parallel group, single-blind clinical trial was performed in 33 patients with ocular hypertension or open angle glaucoma who had not been previously treated. The ocular surface was evaluated prior to and three months after treatment, with a daily drop instillation of one of the three medications. The main outcome measurements included the tear film break-up time, Schirmer's test, Lissamine green staining, the Ocular Surface Disease Index questionnaire, impression cytology using HE and PAS and immunocytochemistry for interleukin-6 and HLA-DR. Ensaiosclinicos.gov.br: UTN - U1111-1129-2872 RESULTS: All of the drugs induced a significant reduction in intraocular pressure. Decreases in the Schirmer's test results were observed with all of the drugs. Decreases in tear-film break-up time were noted with travoprost/timolol and latanoprost/timolol. An increase in the Lissamine green score was noted with travoprost/timolol and bimatoprost/timolol. The Ocular Surface Disease Index score increased after treatment in the travoprost/timolol group. Impression cytology revealed a significant difference in cell-to-cell contact in the same group, an increase in cellularity in all of the groups and an increase in the number of goblet cells in all of the groups. The fixed combinations induced an increase in IL-6 expression in the travoprost/timolol group, in which there was also an increase in HLA-DR expression. CONCLUSIONS: All of the fixed combinations induced a significant reduction in intraocular pressure, and the travoprost/timolol group showed increased expression of the inflammatory markers HLA-DR and interleukin-6. All three tested medications resulted in some degree of deterioration in the ocular surface after three months of glaucoma treatment.

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Published

2013-10-01

Issue

Section

Clinical Sciences

How to Cite

Russ, H. H., Nogueira-Filho, P. A., Barros, J. de N., Faria, N. V. L. de, Montiani-Ferreira, F., Gomes, J. A. P., & Mello, P. A. A. (2013). Ocular surface evaluation in patients treated with a fixed combination of prostaglandin analogues with 0.5% timolol maleate topical monotherapy: a randomized clinical trial. Clinics, 68(10), 1318-1324. https://doi.org/10.1590/clin.v68i10.77008