Biomedical subjects

Yoshiaki Kitazawa

Publications and source records attributed to Yoshiaki Kitazawa.

At least 19 recordsLinked to original sources

PubMed2006

Aqueous humor dynamics associated with the phorbol ester-induced decrease in intraocular pressure in the rabbit.

PURPOSE: To determine the effects of injection of the protein kinase C (PKC) activator phorbol 12-myristate 13-acetate (PMA) into the anterior chamber of the eye on intraocular pressure (IOP) and aqueous humor dynamics. METHODS: IOP was measured for 24 h after intracameral injection of PMA (3 to 50 pmol) in unanesthetized rabbits. Aqueous humor dynamics (aqueous flow, total outflow facility, and uveoscleral outflow) were determined approximately 6 h after injection of 50 pmol of PMA in animals pretreated with indomethacin. RESULTS: Intracameral injection of 50 pmol of PMA induced a biphasic effect on IOP, consisting of a transient increase apparent at 0.5 and 1 h and a sustained decrease apparent after 2 h. This effect of PMA was dose dependent. Whereas pretreatment with indomethacin attenuated the PMA-induced increase in IOP, the sustained decrease in IOP remained apparent in the pretreated rabbits. Intracameral injection of 4alpha-PMA, an inactive PMA analog, had no effect on IOP. PMA also significantly increased uveoscleral outflow, but it had no effect on aqueous flow or total outflow facility. CONCLUSION: Intracameral injection of PMA reduced IOP in the rabbits by increasing the rate of uveoscleral outflow. This IOP-lowering effect of PMA may be mediated by activation of PKC.

Animals↗

PubMed2006

Performance of frequency-doubling technology perimetry in a population-based prevalence survey of glaucoma: the Tajimi study.

OBJECTIVE: To evaluate the performance of frequency-doubling technology (FDT) perimetry in a population-based glaucoma prevalence survey. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Participants older than 40 years randomly selected from the population of Tajimi City. METHODS: Each participant underwent screening ophthalmic examinations including a visual field test using FDT with the C-20-1 screening protocol. A diagnosis of glaucoma was determined by glaucoma specialists with another detailed visual field test using Humphrey Field Analyzer (HFA; Humphrey Instruments, San Leandro, CA) with the 30-2 Swedish interactive threshold algorithm standard protocol and stereoscopic disc photographs. MAIN OUTCOME MEASURES: The ratios of reliable FDT results and the sensitivity and specificity for detecting glaucoma in a general population. RESULTS: Of 5784 eyes of 2892 participants (age range, 40-92 years; refractive error, -23 to 11 diopters) in whom FDT was performed in both eyes, reliable results (< or =33% fixation loss and < or =33% false-positive errors) were obtained in 5707 eyes (98.7%), including 2871 right eyes (99.3%) and 2836 left eyes (98.1%) with a significant bilateral difference (P<0.001, chi-square test). The rate of reliable FDT results did not differ between men and women (P = 0.81) but decreased with age. In 5582 eyes with reliable FDT results, FDT showed 1 or more abnormal points in the visual field in 502 eyes (9.0%), including 388 (7.3%) of 5295 normal eyes, 19 (16.4%) of 116 eyes of glaucoma suspects, and 95 (55.6%) of 171 eyes with definite glaucoma. The sensitivity and specificity values for detecting definite glaucoma were 55.6% and 92.7%, respectively. The positive and negative predictive values were 18.9% and 98.5%, respectively. In further analyses stratified with the mean deviation (MD) of the HFA, the sensitivities were 32.1%, 48.4%, 73.7%, and 96.6% for detecting definite glaucoma with an MD of more than -2 dB, an MD of -2 dB or less and more than -5 dB, an MD of -5 dB or less and more than -8 dB, and an MD of -8 dB or less, respectively. CONCLUSIONS: In a population-based glaucoma screening study, FDT perimetry with the C-20-1 screening protocol was reliably performed in more than 98% of participants. The sensitivity for detecting glaucomatous visual field damages, especially early damage, was not sufficiently high, whereas the specificity was high.

Adult↗

PubMed2006

Risk factors for open-angle glaucoma in a Japanese population: the Tajimi Study.

PURPOSE: To identify the risk factors associated with primary open-angle glaucoma (POAG) in the Tajimi Study. DESIGN: Population-based cross-sectional epidemiologic study. PARTICIPANTS: One hundred nineteen POAG patients and 2755 controls. METHODS: Univariate and multivariate comparison of ocular factors and systemic factors between POAG patients and controls. MAIN OUTCOME MEASURES: Difference in factors between POAG patients and controls, factors associated with POAG patients, and their odds ratio (OR). RESULTS: Intraocular pressure (IOP), age, myopia, and history of hypertension differed between POAG patients and controls in univariate analyses. Multivariate analysis with logistic regression with stepwise selection of variables demonstrated that higher IOP (OR, 1.12 [95% confidence interval (CI), 1.04-1.21]), myopia (ORs, 1.85 [95% CI, 1.03-3.31] for low myopia and 2.60 [95% CI, 1.56-4.35] for moderate to high myopia), and older age (OR, 1.06 [95% CI, 1.04-1.08]) were associated with an increased risk of having POAG. CONCLUSIONS: Although the majority (92%) of POAG patients diagnosed in the Tajimi Study had IOP within the normal range, IOP was still identified as a significant risk factor for POAG. Together with IOP, myopia and age were significant risk factors for having POAG.

Age Factors↗

PubMed2006

Morphometric evaluation of changes with time in optic disc structure and thickness of retinal nerve fibre layer in chronic ocular hypertensive monkeys.

We examined the time course of changes in optic disc structure by means of a scanning laser ophthalmoscope (Heidelberg Retina Tomograph, HRT) in ocular hypertensive (experimental glaucoma) monkeys, and clarified the relationships between the histological RNFL thickness and HRT parameters. Further, the time course of changes in retinal nerve fiber layer (RNFL) thickness in individual eyes was measured using a scanning laser polarimeter with fixed corneal polarization compensator (GDx FCC). In the present study, two separate experiments were carried out. A chronic intraocular pressure (IOP) elevation was induced by laser trabeculoplasty in the left eye in 11 cynomolgus monkeys. In Experiment 1, the HRT and GDx parameters were measured 12 weeks after the laser treatment in 10 eyes in five monkeys. In Experiment 2, the time course of changes in the HRT and GDx parameters was examined before and 1, 3, 4, 5, 6, 8, 10, 12, 14, and 16 weeks after the laser treatment in 12 eyes in six monkeys. The retardation values (thickness parameters) obtained from the GDx were used to derive thickness and ratio parameters in the superior, inferior, nasal and temporal quadrants. Ratio parameters were expressed as a ratio of superior and inferior quadrant to nasal quadrant. After the last measurements, each eye was enucleated, and retinal cross sections were prepared for histological analysis. In the left (hypertensive) eyes, IOP was persistently elevated throughout the observation periods in both Experiments 1 and 2. In the HRT measurements in Experiment 1, seven out of eight global topographic parameters (exception, disc area) were statistically different between the hypertensive and control eyes 12 weeks after the laser treatment. In Experiment 2, the HRT parameters changed in a time-dependent manner, but each of them almost plateaued at about 4 weeks after the laser treatment. Significant correlations were seen between the histological mean RNFL thickness at 1.5 disc diameters from the optic disc margin and the HRT parameters in 21 eyes from 11 monkeys in Experiments 1 and 2. Especially good correlations with histological mean RNFL thickness were seen for the rim volume and cup volume. In Experiment 1, good correlations were found between GDx ratio parameters and histological RNFL thickness in individual right control eyes (n=5). In individual left experimental glaucoma eyes of Experiment 2 (n=6), GDx ratio parameters declined in a time-dependent manner alongside the IOP elevation. In conclusion, alongside the IOP elevation, time-related changes in optic disc topography and RNFL thickness were demonstrated in monkey eyes using HRT and GDx. HRT (rim and cup) parameters showed good correlations with histological RNFL thickness, and significant interrelations.

Animals↗

PubMed2006

Prevalence and causes of low vision and blindness in a Japanese adult population: the Tajimi Study.

OBJECTIVE: To determine the prevalence and causes of low vision and blindness in a Japanese adult population. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Randomly selected residents (n = 3870) of Tajimi City, Japan, who were 40 years of age or older. METHODS: Of the 3021 study participants (78.1% of 3870 eligible persons), 2977 (76.9%) underwent a complete ophthalmologic examination including measurement of the best-corrected visual acuity (BCVA) with full subjective refraction using a Landolt ring chart at 5 m. Age- and gender-specific prevalence rates of low vision and blindness were estimated and causes were identified. MAIN OUTCOME MEASURES: Low vision and blindness were defined as BCVA in the better eye worse than 20/60 to a lower limit of 20/400 and worse than 20/400, respectively (World Health Organization [WHO] criteria) and worse than 20/40 but better than 20/200 and 20/200 or worse, respectively (United States criteria). RESULTS: The overall prevalence of blindness according to the WHO or U.S. criteria was 0.14% (n = 4; 95% confidence interval [CI], 0.06-0.32). The primary causes were optic atrophy, myopic macular degeneration, retinitis pigmentosa, and uveitis. The overall prevalence of low vision according to the WHO criteria was 0.39% (95% CI, 0.18%-0.60%) and according to the U.S. criteria was 0.98% (95% CI, 0.66%-1.30%), which was significantly greater in women and in the older half of the participants than in the younger half (P = 0.0079 and <0.0001, respectively). The leading causes of low vision in descending order were cataract followed by glaucoma, and those of monocular blindness were myopic macular degeneration, glaucoma, and trauma. CONCLUSIONS: The prevalence of low vision and blindness in Japanese adults was one of the lowest among those reported. The major causes of low vision were cataract and glaucoma, and the leading cause of monocular blindness was myopic macular degeneration.

Aged↗

PubMed2006

Phase III long-term study and comparative clinical study of nipradilol ophthalmic solution in patients with primary open-angle glaucoma and ocular hypertension.

Nipradilol (CAS 81486-22-8) is a non-selective beta-blocker with alpha-1 blocking and nitroglycerin-like vasodilating activities. In the present communication, the long-term efficacy and safety of nipradilol were investigated and the efficacy, safety and utility of topical nipradilol and timolol (CAS 91524-16-2) were compared in patients with primary open-angle glaucoma or ocular hypertension. In the long-term study, nipradilol for 1 year (52 weeks) was performed by registration method. 67 out of 68 patients were subjected to analysis and 57 patients (83.8 %) completed 52-week instillation. 0.25 % nipradilol was applied twice daily to patients. As a result, intraocular pressure (IOP) decreased significantly by 4.0 mmHg to 4.8 mmHg compared with the baseline without tachyphylaxis. The incidence of adverse events was 12.5 % at 52 weeks by analysis with Kaplan-Meier life-table method. It showed no significant trend of increase after 3 months. In the multi-centered double-masked comparative randomized study, 0.25 % nipradilol was assigned to 96 patients and 0.5 % timolol to 100 patients. Each patient was instilled nipradilol or timolol twice daily for 8 weeks. IOP significantly decreased by 4.2 mmHg and by 4.7 mmHg at 8 weeks and the incidence of adverse events was 10.5 % and 12.1 % in the nipradilol and timolol group, respectively. No significant between-group difference in IOP reduction or incidence of adverse events was seen. Topical nipradilol showed long-term ocular hypotensive effects and clinical safety in a 52-week study, and its efficacy and safety equivalent to timolol was confirmed in a 8-week comparative study.

Administration, Topical↗

PubMed2006

Incidence of disc hemorrhages in open-angle glaucoma before and after trabeculectomy.

PURPOSE: To investigate the effects of reduction of intraocular pressure (IOP) by surgical intervention on the frequency of disc hemorrhages in eyes with primary open-angle glaucoma (POAG) and normal-tension glaucoma (NTG). DESIGN: Retrospective study. METHODS: We studied 99 eyes of 99 patients with POAG and 50 eyes of 50 patients with NTG, who underwent trabeculectomy with adjunctive mitomycin C (MMC) and were followed regularly at 1 to 3-month intervals at the Glaucoma Service of Gifu University Hospital. We applied Kaplan-Meier life-table analysis for the detection of disc hemorrhages before and after trabeculectomy. RESULTS: Trabeculectomy significantly reduced IOP (in POAG: 19.6 +/- 4.4 down to 11.1 +/- 4.2 mm Hg; in NTG: 15.3 +/- 1.5 down to 11.3 +/- 4.5 mm Hg; mean +/- SD). Life-table analysis revealed that the final cumulative probability of detecting a disc hemorrhage after surgery in POAG was 5.5 +/- 2.2% (calculated probability +/- SE) and was significantly lower than that (33.4 +/- 7.8%) before surgery (P < 0.0001, log-rank test). Likewise, the final probability after surgery in NTG was 23.1 +/- 6.3% and was significantly lower than that (42.1 +/- 8.8%) before surgery (P = 0.0063, log-rank test). CONCLUSIONS: IOP reduction via surgical intervention significantly decreases the frequency of disc hemorrhages in open-angle glaucoma patients.

Adult↗

PubMed2005

The Tajimi Study report 2: prevalence of primary angle closure and secondary glaucoma in a Japanese population.

PURPOSE: To determine the prevalence of primary angle-closure glaucoma (PACG), secondary glaucoma (SG), and all glaucoma in a Japanese population as a part of the Tajimi Study. DESIGN: Population-based epidemiological survey. PARTICIPANTS: A random sample of residents 40 years or older from Tajimi, Japan. INTERVENTION: Each subject underwent a screening program comprising an interview and an ophthalmic examination, including Goldmann applanation tonometry, slit-lamp examination, a van Herick test, fundus photography, and a screening visual field (VF) test using frequency-doubling technology. If glaucoma was suspected, the subject was referred for a definitive examination that included slit-lamp examination, gonioscopy, intraocular pressure measurement, a VF test, and optic disc and fundus examination. A diagnosis of PACG or SG was made based on slit-lamp examination, gonioscopy, optic disc appearance, and perimetric results. MAIN OUTCOME MEASURES: Prevalences of PACG, SG, and all cases of glaucoma. RESULTS: Of 3870 eligible people, 3021 (78.1%) participated in the study. Estimated prevalences of PACG and SG in those over 40 years were 0.6% (95% confidence interval [CI], 0.4%-0.9%) and 0.5% (95% CI, 0.2%-0.7%), respectively. Prevalences of all glaucoma and glaucoma/suspected glaucoma were estimated to be 5.0% (95% CI, 4.2%-5.8%) and 7.5% (95% CI, 6.5%-8.4%), respectively. CONCLUSIONS: Prevalences were 0.6%, 0.5%, and 5.0%, respectively, for PACG, SG, and all glaucoma in subjects over 40 years from Tajimi, Japan.

Adult↗

PubMed2004

Gold standard medical therapy for glaucoma: defining the criteria identifying measures for an evidence-based analysis.

BACKGROUND: Over the past decade, several new medical therapies have become available for the treatment of primary open-angle glaucoma (POAG). A systematic evidence-based approach for identifying an optimal therapeutic agent is lacking. OBJECTIVES: The aims of this review were to critically evaluate published treatment recommendations for POAG and, based on a systematic review of the literature, to develop criteria that would define a "gold standard" medical therapy that reflects new treatment advances and established therapeutic goals. METHODS: A MEDLINE search spanning the years 1966 to 2002 and using the search terms gold standard, drug of choice, agent of choice, benchmark, ophthalmology, eye, and glaucoma was conducted and the results reviewed by a panel of 15 experts in the field of glaucoma. Published treatment recommendations for POAG were discussed. Criteria, anchored to medical evidence, for distinguishing a standard of medical therapy for POAG were defined. RESULTS: The terms connoting a gold standard therapy were found in only 258 of approximately 368,000 ophthalmology-related citations and 53 of almost 23,000 glaucoma citations, validating the need to define therapeutic standards. The lack of recommendations for the use of new classes of ocular hypotensive agents was acknowledged. Criteria identified to evaluate intraocular pressure (IOP)-lowering agents as gold standards included the following: efficacy in reducing IOP consistently over a 24-hour period to a level that will preserve the visual field and protect the optic nerve without inducing tachyphylaxis and tolerance, paucity of local and systemic adverse effects, promotion of patient compliance, and applicability in diverse patient populations. CONCLUSIONS: These criteria should be employed as measures for evidence-based analyses to evaluate available and future IOP-lowering medical therapies for POAG. The conceptual framework presented may be applicable to other therapeutic areas.

Adrenergic beta-Antagonists↗

PubMed2004

The prevalence of primary open-angle glaucoma in Japanese: the Tajimi Study.

PURPOSE: To assess the prevalence of primary open-angle glaucoma (POAG) and its association with intraocular pressure (IOP) in Tajimi City in central Japan. DESIGN: A cross-sectional epidemiologic study in a defined population. PARTICIPANTS: Subjects randomly selected from the population older than 40 years in Tajimi City. INTERVENTION: Each subject underwent a screening examination comprised of an interview and ophthalmic examinations, including measurement of IOP by a Goldmann applanation tonometer, central corneal thickness (CCT), slit-lamp examination, fundus photography, and a screening visual field test using frequency doubling technology. When ocular diseases were suspected, the subjects were referred for definitive examination. During the definitive examination, slit-lamp examination, IOP measurement, a visual field test using Humphrey Field Analyzer 30-2 SITA Standard program (Humphrey Instruments, San Leandro, CA), optic disc and fundus examination, and gonioscopy were performed and stereoscopic disc photographs were obtained. A diagnosis of glaucoma was made based on optic disc appearance, perimetric results, and other ocular findings. MAIN OUTCOME MEASURES: Prevalence of POAG, mean IOP, and mean CCT. RESULTS: Of 3870 eligible people, 3021 (78.1%) participated in the study. The estimated prevalence of POAG in the population older than 40 years was 3.9% (95% confidence interval [CI]), 3.2%-4.6%). The prevalence of cases of POAG with IOP levels of 21 mmHg or less was 3.6% (95% CI, 2.9%-4.3%), whereas the prevalence for those with IOP levels of more than 21 mmHg was 0.3% (95% CI, 0.1%-0.5%). The average IOP for eyes with POAG was 15.4+/-2.8 (standard deviation) in the right eye (n = 115) and 15.2+/-2.8 mmHg in the left eye (n = 115), which was significantly higher than that of nonglaucoma subjects (14.5+/-2.5 in the right eye; n = 2759; P = 0.0004; and 14.4+/-2.6 mmHg in the left eye; n = 2757; P = 0.0026). The mean CCT of POAG eyes with IOP levels of 21 mmHg or less was 518+/-29 (n = 109) in the right eye and 519+/-29 microm (n = 110) in the left eye, levels that were not significantly different from that of nonglaucoma eyes (520+/-32 microm [n = 2690]; and 522+/-32 microm [n = 2692]; P>0.05). CONCLUSIONS: The prevalence of POAG in this population was 3.9%. In 92% patients with POAG, the IOP was 21 mmHg or less.

Adult↗

PubMed2004

Statistical evaluation of the diagnostic accuracy of methods used to determine the progression of visual field defects in glaucoma.

OBJECTIVE: To evaluate trend-type analyses to judge the progression of visual field damage (VFD) of glaucoma in terms of ratios of making judgments of progression and specificity, and to report a new method. DESIGN: Retrospective analysis of visual field (VF) results of actual glaucoma cases and those simulated by computer, and receiver operating characteristic curve analysis of performance of methods to judge the progression of VFD. PARTICIPANTS: One hundred five eyes of 105 open-angle glaucoma (OAG) patients with progressing VFD and 355 eyes of 355 clinically stable OAG patients for VF simulation from 4 university-based referral practices. METHODS: Methods using regression analysis of total deviation (TD), mean deviation (MD), mean TD of a sectored VF, and original scoring used in the Advanced Glaucoma Intervention Study (AGIS) were compared. A VF test was repeated twice in a short period on the 355 stable OAG eyes, and test-retest fluctuation, including variance at each test point and covariance between 2 test points, was calculated to simulate stable glaucomatous VF series by computer. The sensitivity of each method was calculated with 105 progressing VF series, and specificity was calculated with 10,000 simulated stable glaucomatous VF series. MAIN OUTCOME MEASURES: Sensitivity (ratios of making judgments of progression), specificity, and diagnostic power. RESULTS: The methods using the TD slope on one test location showed a sensitivity of 0.848 to 1.000, with a specificity of 0.105 to 0.721, and on 2 adjacent test locations showed a sensitivity of 0.848, with a specificity of 0.722. A significant negative MD slope with P<0.05 showed a sensitivity of 0.524, with a specificity of 0.945. The method using a sectored VF showed a sensitivity of 0.695, with a high specificity of 0.946. The AGIS method showed a sensitivity of 0.305 to 0.467, with a very high specificity of 0.999 to 1.000. The method using previously reported mathematically sectored VFs showed a sensitivity of 0.790, with a specificity of 0.900, and higher diagnostic power (1.69) than the others in this study population. CONCLUSIONS: Most of the methods using the TD slope were characterized by high sensitivity, the AGIS method had a very high specificity, and those using VF sectors had reasonable sensitivity and specificity.

Adolescent↗

PubMed2004

The effect of alpha2-agonist on IOP rise following Nd-YAG laser iridotomy.

We have tested the effect of topical administration of 0.5% para-amino-clonidine (PAC), an adrenergic alpha 2 agonist, on intraocular pressure (IOP), protein and prostaglandin E2 (PGE2) concentration in aqueous humor following the laser application to the iris of albino rabbits. The irides received Q-switched Nd: YAG laser irradiation with the energy level ranging from 2 to 80 mJ with and without topical administration of PAC one-hour prior to and immediately following laser irradiation. The IOP was measured with an Alcon pneumotonometer prior to and hourly for 6-hours following laser application. Aqueous humor was withdrawn prior to and at 0.5, 1, 2, 4 hours following laser irradiation for determining protein (Lowry method) and PGE2 (radioimmunoassay). Four to 6 rabbits were used for each experiment. The increase in IOP, protein and PGE2 concentration following laser irradiation was demonstrated to be dependent on the amount of laser energy. PAC significantly suppressed the IOP rise and the elevation of protein content, while it failed to affect the increase in PGE2.

Adrenergic alpha-Agonists↗

PubMed2003

Characteristics of visual field progression in patients with normal-tension glaucoma with optic disk hemorrhages.

PURPOSE: To study the characteristics of visual field progression in patients with normal-tension glaucoma (NTG) with optic disk hemorrhages. DESIGN: Observational study. METHODS: Fifty-eight eyes of 58 untreated patients with NTG who had at least five reliable visual fields of the Humphrey Field Analyzer (central 30-2) within the follow-up period of more than 24 months were enrolled. Of these, 27 eyes had optic disk hemorrhages in their clinical courses. Pointwise linear regression analysis was done using total deviation values of the fields at each of 74 test locations in each patient. Progression was defined as the points of negative slopes with P <.01. A whole visual field was concentrically divided into three clusters: the areas within 10 degrees, 10 to 20 degrees, and 20 to 30 degrees. Percentages of the progressed points of the three clusters and a whole field were compared between the groups with and without optic disk hemorrhages. RESULTS: No significant differences were found in patients' backgrounds, including initial mean deviation values, follow-up periods, and the number of visual field examinations between the 27 patients with optic disk hemorrhages and the 31 without. The group with optic disk hemorrhages showed significantly higher percentages of progressed points within the 10-degree area compared with the group without optic disk hemorrhages (mean +/- SD: 13.1 +/- 13.7%; 5.1 +/- 8.5%, respectively; P =.0086, Student t test), whereas no significant differences were found in the other two clusters or in a whole field. CONCLUSIONS: Patients with NTG with optic disk hemorrhages tend to show visual field progression in areas within 10 degrees.

Adult↗

PubMed2003

The efficacy and safety of dose escalation of dorzolamide used in combination with other topical antiglaucoma agents.

We investigated the dose-escalation profile of dorzolamide used in combination with other antiglaucoma agents in patients with primary glaucoma and ocular hypertension. In a prospective, open-label study, 78 patients received dorzolamide 0.5% in addition to other topical antiglaucoma agents for > or =4 weeks. The concentration of dorzolamide was then escalated to 1.0% and intraocular pressure (IOP) measured every 4 weeks for 12 weeks. Dose escalation of dorzolamide from 0.5% to 1.0% resulted in a significant reduction in IOP throughout the 12 weeks of treatment at the higher dose. Mean baseline IOP was 19.7 mmHg. At 4, 8, and 12 weeks after dose escalation, mean IOP had decreased to 17.8 (-9.4%), 17.6 (-10.8%), and 17.5 (-10.7%) mmHg. No serious drug-related adverse effects were reported. These results indicate that dose escalation of dorzolamide from 0.5% to 1.0% is effective and well tolerated as adjunctive therapy for patients in whom IOP is insufficiently controlled by combination therapy.

Administration, Topical↗

PubMed2002

Current status of prostaglandin therapy: latanoprost and unoprostone.

Latanoprost, a prostaglandin F(2alpha) analog prodrug, and unoprostone, an analog of a prostaglandin metabolite, have been shown to be effective in decreasing intraocular pressure when used alone or in combination with other ocular hypotensive agents. The increase in the uveoscleral outflow and some of the side effects are probably FP-receptor mediated, which may account for some differences between the cited drugs. This article reviews the recent literature available on the clinical efficacy of these prostanoids, as well as the studies directly comparing these drugs.

Antihypertensive Agents↗

PubMed2002

Myopia and advanced-stage open-angle glaucoma.

OBJECTIVE: To investigate the effect of myopic refraction on the central visual field in patients with advanced open-angle glaucoma (OAG). DESIGN: Multicenter cross-sectional study. PARTICIPANTS: Three hundred thirteen OAG eyes (176 eyes of 176 primary open-angle glaucoma [POAG] patients and 137 eyes of 137 normal-tension glaucoma [NTG] patients) with clear ocular media and a mean deviation (MD) <-15 dB. Patients with a recorded maximum intraocular pressure (IOP) of 22 mmHg or greater were classified as POAG, and those with an IOP of 21 mmHg or less were classified as NTG. METHODS: Multiple regression analysis was used to study the influence of refraction on 12 central test points of the C30-2 Humphrey program, and the differences in visual field defects between POAG and NTG eyes were examined using logistic discriminant analysis. In the multiple regression analysis, total deviation (TD) of the 12 test points was graded and used as the dependent variable, and MD and the spherical equivalent refraction were the explanatory variables. In the logistic discrimination analysis, TD, MD, and refraction were covariants that determined the OAG subtypes. MAIN OUTCOME MEASURES: TD values of the 12 central test points (C30-2 program). RESULTS: Higher myopic refraction was significantly associated with more damage at a point just temporal and inferior to the fixation point in POAG eyes, whereas it was significantly associated with less damage at test points just temporal and superior to the fixation point in NTG eyes. After correcting for the influence of refraction, POAG eyes had significantly more damage at a test point just temporal and inferior to the fixation point, whereas NTG eyes had significantly more damage at those test points nasal and inferior to the fixation point. CONCLUSIONS: High myopia constitutes a threat to the remaining lower cecocentral visual field and is one of the factors that interfere with the quality of vision in advanced OAG with high IOP but not low IOP.

Cross-Sectional Studies↗

PubMed2002

A comparative clinical study of latanoprost and isopropyl unoprostone in Japanese patients with primary open-angle glaucoma and ocular hypertension.

PURPOSE: To compare the efficacy and safety of latanoprost versus isopropyl unoprostone (unoprostone) in Japanese patients with primary open-angle glaucoma (POAG) or ocular hypertension (OH). METHODS: An 8-week, multicenter, randomized, comparative study was performed in 48 Japanese patients with POAG or OH. Four patients (two in each group) withdrew from the study, but their data were included in the safety assessment but not in the intraocular pressure (IOP) evaluation. The patients were randomly treated with latanoprost 0.005% once daily or unoprostone 0.12% twice daily for 8 weeks. IOP was measured at baseline and 2, 4, and 8 weeks after treatment. In addition, ocular and systemic adverse events were recorded. RESULTS: The baseline IOPs were similar between the latanoprost (n = 25) and unoprostone (n = 19) groups (24.3 +/- 2.4 mm Hg vs 23.3 +/- 2.1 mm Hg, respectively, = 0.18). The IOP reductions from baseline at 2, 4, and 8 weeks after treatment were 5.8 +/- 2.4, 6.6 +/- 2.5, and 6.7 +/- 2.0 mm Hg in the latanoprost group, and 3.8 +/- 2.0, 3.5 +/- 2.3, and 3.3 +/- 3.0 mm Hg in the unoprostone group, respectively. The IOP reduction in the latanoprost group at 8 weeks was larger than that in the unoprostone group ( < 0.001, analysis of covariance). Five adverse events were observed in 4 (15%) of 27 patients in the latanoprost group, and five adverse events were observed in 4 (20%) of 21 patients in the unoprostone group. There was no difference in the incidence of adverse events between groups ( = 0.71). CONCLUSION: Latanoprost produced a statistically greater reduction in IOP than unoprostone in Japanese patients with POAG or OH.

Antihypertensive Agents↗

PubMed2002

Specificity and sensitivity of glaucoma detection in the Japanese population using scanning laser polarimetry.

AIMS: To investigate the usefulness of the scanning laser polarimeter (GDx; GDx Nerve Fiber Analyzer) for glaucoma detection in the Japanese population, and to investigate the difference in the thickness of retinal nerve fibre layer (RNFL) between normal tension glaucoma (NTG) and primary open angle glaucoma (POAG). METHODS: 69 eyes of 69 normal subjects and 115 eyes of 115 chronic open angle glaucoma patients (60 NTG and 55 POAG patients) were studied. The thickness of RNFL was measured with GDx. An eye was diagnosed as glaucomatous, if at least one original GDx variable showed p <5%. The difference in thickness of RNFL between the NTG and POAG groups was then investigated. RESULTS: 46 normal eyes (66.7%) were diagnosed as not glaucomatous (no variables showing p <5%), and 93 glaucomatous eyes (46 NTG and 47 POAG eyes) (80.9%) were diagnosed as glaucomatous. Actual values of average thickness, ellipse average, superior average, and superior integral were significantly lower in the POAG group than those in the NTG group. CONCLUSIONS: New variables which elucidate focal RNFL defects or early changes are needed to improve the moderate detection ability found in this present study. The pattern of the change in RNFL may differ in NTG and POAG groups.

Adult↗