Effectiveness of antihypertensive conservative-free therapy with fixed combination of bimatoprost and timolol (intermediate results)

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Introduction. The effects of antihypertensive therapy are often determined by patient compliance with the prescribed treatment plan. Acceptance of conservative-free forms of drugs leads to a decrease in the frequency and severity of side effects, reduces the need for the use of artificial tears, which lowers the cost of treatment for the patients. Purpose — to evaluate the hypotensive effectiveness of a fixed combination of bimatoprost (0.03%) and timolol (0.5%), and its effect on the ocular surface in patients with newly diagnosed advanced glaucoma. Material and methods. The study was conducted during February—November 2018, and included 46 patients (76 eyes) with newly diagnosed POAG and healthy volunteers (control group). All patients underwent visometry, ICare rebound tonometry (Tiolat, Finland), elastometry with Maklakov tonometer (using 5 g, 10 g and 15 g loads), automated perimetry (AP) (Octopus-600, Haag-Streit diagnostics, Switzerland), optical coherence tomography (OCT) of the macular zone and optic nerve head, pachymetry (Spectralis OCT, Heidelberg Engineering, Germany). At the start of the study and one month after the start of treatment with the drug Ganfort (Allergan, USA), patients were examined to evaluate the state of their ocular surface: Norn’s test, Schirmer’s test, vital staining with lissamine green, and an OSDI questionnaire. Results. At the start of treatment, administration of a fixed combination of bimatoprost and timolol led to a decrease in intraocular pressure by 7.9 (37.7%) mm Hg (V=271, p=5.496e—05) after 2 weeks of the use of Ganfort (Allergan, USA). During this period, the observation group did not exhibit statistically significant changes in the state of the ocular surface, which was comparable to the control group according to the data of the Norn’s test, Schirmer’s test, vital staining with lissamine green and the OSDI questionnaire (p>0.05). Conclusion. The use of a fixed combination of bimatoprost and timolol, while effectively reducing IOP, did not result in statistically significant changes in the ocular surface. Some improvement of both objective and subjective indicators of the state of ocular surface associated with the use of the Ganfort drug was noted in patients of the observation group.

Keywords:

glaucoma

dry eye syndrome

ocular surface

intraocular pressure

antihypertensive therapy

Authors:

Dorofeev D.A.

Chair of Surgical diseases №2, Medical Institute of Tula State University, Tula, Russia

Kryzhanovskaya A.V.

South Ural State Medical University, Chelyabinsk, Russia

Ciganov A.Z.

South Ural State Medical University, 64 Vorovskogo St., Chelyabinsk, Russian Federation, 454092

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