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At least 487 records · Page 27Linked to original sources
PubMed1983

Timoptol--three years on. A study of timolol maleate drops over a longer period.

A group of 130 patients with chronic glaucoma has been followed from one to more than three years on timolol maleate drops; this confirms that these drops remain effective in long-term therapy through added therapy is usually needed. Of 54 patients originally controlled by timolol alone or in combination, only four were not controlled more than three years later, though some needed further additional therapy. Of 35 patients followed for two to three years, only six could not be controlled by timolol alone or in combination; and of 41 followed for one to two years, 18 were controlled on timolol alone while 23 needed additional therapy. Attention is drawn to side effects including a mild keratopathy and in particular the occurrence of bronchospasm or other severe respiratory disease in 10 patients, not all of whom had a previous history of respiratory disease. Great care should be exercised with timolol in the presence of present or past respiratory disease as the complication is not generally recognised and it falls to the ophthalmologist to act to stop the drop.

Drug Therapy, Combination↗
PubMed1989

A comparison of the efficacy of betaxolol and timolol in ocular hypertension with or without adrenaline.

Betaxolol hydrochloride, a selective beta 1-adrenergic blocker, is claimed to be less likely to aggravate chronic obstructive airways disease than timolol maleate, a nonselective beta-blocker. It is not clear which drug is more effective in lowering intraocular pressure (IOP) and how each acts in combination with topical adrenaline. To assess this we conducted a randomised clinical trial on ocular hypertensive patients. Both betaxolol and timolol produced a significant fall in IOP though not in all patients. No significant difference was found between betaxolol and timolol. The addition of dipivefrin gave an additional fall in some eyes only. No significant difference was found between the addition of dipivefrin and adrenaline. Some fellow eyes had a fall in IOP when dipivefrin was added to timolol. It is important to assess the response carefully in each individual eye when using betaxolol or timolol or when adding additional medication.

Adrenergic beta-Antagonists↗
PubMed2003

AC/A ratios in myopic and emmetropic Hong Kong children and the effect of timolol.

PURPOSE: Caucasian children with myopia have elevated response accommodative vergence to accommodation (AC/A) ratios. The purpose of this study was twofold: to determine if response AC/A ratios vary with refractive error and with myopic progression rate in Hong Kong Chinese children, and to determine the effect of beta-adrenergic antagonism with topical timolol application on AC/A ratios. METHODS: Thirty children aged eight to 12 years participated in the study. All refractive errors were corrected with spectacle lenses. Accommodative responses were measured using a Shin-Nippon autorefractor and concurrent changes in vergence were assessed using a vertical prism and a Howell-Dwyer card at three metres and 0.33 metre. Accommodative demand was altered using plus or minus two dioptre lenses and lens- and distance-induced response AC/A ratios were calculated. Measurements were repeated 30 minutes after the instillation of topical timolol maleate (0.5 per cent). RESULTS: AC/A ratios appeared higher in progressing myopic children but the difference was not statistically significant. Timolol application reduced accommodative convergence (AC) in the stable myopes (reduction = -3 +/- 1.14 prism dioptres) but not in the emmetropes (0.69 +/- 0.96 prism dioptres) or progressing myopes (0.16 +/- 0.43 prism dioptres) and this difference between refractive groups was statistically significant (F(2, 27) = 3.766; P = 0.036). However, timolol did not produce a significant change in the accommodative response to positive or negative lenses or response AC/A ratios. CONCLUSIONS: We did not find that AC/A ratios in myopic Chinese children were elevated and therefore, it is unlikely that elevated AC/A ratios are responsible for the high levels of myopia that occur in Hong Kong. The finding that timolol reduced AC in the stable myopes suggests that the autonomic control of accommodative convergence in these children may be different from that in emmetropic children and those with progressing myopia.

Accommodation, Ocular↗
PubMed1995

Decrease of optic disc cupping and pallor of ocular hypertensives with timolol therapy.

PURPOSE: The purpose of this study was to determine whether timolol drops compared to placebo drops had a significant effect on optic disc cupping and pallor in ocular hypertensives. METHODS: Thirty-seven ocular hypertensives were randomly assigned to placebo or 0.5% timolol drops to both eyes in a double masked clinical trial. Measurements of ocular pressure and photographs of the optic disc for cupping by photogrammetry and pallor by computerized image analysis were made at about 3 month intervals, for 18 to 24 months of follow-up. RESULTS: None of the subjects developed visual field loss when tested with the Goldmann perimeter by kinetic and static means at six month intervals. Subjects treated with timolol developed a significant decrease in ocular pressure and a significant decrease in optic disc cupping with a smaller decrease in pallor compared to subject treated with placebo. Multivariate analyses indicated that the decrease of optic disc cupping and pallor was not associated with the ocular pressure on treatment or the decrease in ocular pressure during the trial. CONCLUSION: Timolol treatment was associated with a decrease in optic disc cupping and pallor. The effect of timolol appears to be related to mechanisms other than the decrease in ocular pressure.

Double-Blind Method↗
PubMed1995

Increase of retinal nerve fiber layer thickness in ocular hypertensives with timolol therapy.

PURPOSE: The purpose of this study was to determine whether timolol drops compared to placebo drops had a significant effect on retinal nerve fiber layer thickness in ocular hypertensives. METHODS: Thirty-seven ocular hypertensives were randomly assigned to receive placebo or 0.5% timolol drops to both eyes for 18 to 24 months in a double masked clinical trial. Measurements of ocular pressure and photographs of retinal nerve fiber layer using stereophotogrammetric techniques were made at about 3 month intervals for 18 to 24 months of follow-up. RESULTS: None of the subjects developed visual field loss when tested with the Goldmann perimeter by kinetic and static means at six month intervals. Subjects treated with timolol had a significant decrease in ocular pressure and developed a significant increase in retinal nerve fiber layer thickness compared to subjects treated with placebo. Multivariate analyses indicated that the increase of retinal nerve layer thickness was not associated either with the ocular pressure on treatment or the decrease in ocular pressure on treatment. CONCLUSION: Timolol treatment was associated with an increase of retinal nerve fiber thickness. The effect of timolol appears to be related to mechanisms other than the decrease in ocular pressure.

Double-Blind Method↗
PubMed1995

Increase of retinal vessel width in ocular hypertensives with timolol therapy.

PURPOSE: The purpose of this study was to determine whether timolol drops compared to placebo drops had a significant effect on retinal vessel width in ocular hypertensives. METHODS: Thirty-seven ocular hypertensives were randomly assigned to receive placebo or 0.5% timolol drops to both eyes for 18 to 24 months in a double masked clinical trial. Measurements of ocular pressure and retinal vessel width by computerized image analysis from fundus photographs were made at about 3 month intervals for 18 to 24 months of follow-up. RESULTS: None of the subjects developed visual field loss when tested with the Goldmann perimeter by kinetic and static means at six month intervals. Subjects treated with the placebo showed no change in ocular pressure and a significant decrease in retinal vessel width over time especially in the right eye. Subjects treated with timolol had an increase in retinal vessel width compared to the placebo group significant especially for the superior temporal vein. Multivariate analyses indicated that the increase of retinal vessel width was not associated mainly with the ocular pressure on treatment or decrease in ocular pressure on treatment. CONCLUSION: Timolol treatment was associated with an increase of retinal vessel width. The effect of timolol appears to be related primarily to mechanisms other than the decrease in ocular pressure.

Double-Blind Method↗
PubMed1979

Timolol in maintenance treatment of ocular hypertension and glaucoma.

The hypotensive effect of Timolol eye drops (0.25 and 0.50%) in maintenance treatment of 64 patients with elevated intraocular pressure has been studied. The patients were treated for a period of mean 13 months. In 44 patients mostly comprising ocular hypertensives, a significant reducation in IOP (32%) could be maintained with Timolol alone (P less than 0.001). In patients with a high starting baseline pressure of previous maladjustable glaucoma it was necessary to start combined treatment. Pilocarpine, epinephrine or acetazolamide appeared to have additive pressure-lowering effect to Timolol. A significant correlation was present between pre-treatment and Timolol treated intraocular pressures. Thus a pre-treatment IOP above 25 mmHg may indicate a critically hypotensive effect below an IOP of 20 mmHg with Timolol alone. No significant interfernce with visual acuity, pupullary size, blood pressure, or pulse rate was noted. Existing visual field defects in three patients were slightly aggravated and in four patients, with a pathological optic disc, visual field loss developed. In seven patients transient sensations of dry eyes and rose-bengal staining dots on the cornea developed.

Acetazolamide↗
PubMed1979

The long-term hypotensive effect of timolol maleate compared with the effect of pilocarpine in simple and capsular glaucoma.

The long-term intraocular pressure (IOP) lowering effect of a beta-adrenergic blocking agent, timolol maleate, in topical administration was compared with the effect of pilocarpine on simple and capsular glaucoma by means of diurnal pressure curves during a six-month follow-up. In simple glaucoma timolol was more effective than pilocarpine in lowering IOP. In the follow-up a significant but not marked increase of the IOP was observed. In capsular glaucoma timolol was not effective enough, but when it was co-administered with miotics the IOP lowering effect was better than with either substance alone. Timolol induced no accomodative myopia, miosis, reduction of tear flow or other side effects. It increased the outflow facility in simple glaucoma but not in capsular glaucoma. During the trial, the anterior chamber depth increased while the corneal thickness remained unchanged. Four out of the six eyes included in a previous report of secondary glaucoma due to chronic uveitis are still, after one year of therapy, controlled with timolol.

Adrenergic beta-Antagonists↗
PubMed1981

Timolol and metoprolol in glaucoma. A comparison of the ocular hypotensive effect, local and systemic tolerance.

A double-masked cross-over comparison of the ocular hypotensive effect in 19 glaucoma patients between timolol 0.5% - a non-selective beta-blocking agent - and metoprolol 3% - a beta 1-selective blocking agent - disclosed a greater pressure lowering effect (mean 9%, median 7% more) with timolol in a treatment period of 1 month. In patients on timolol treatment 47% - 60% of the eyes could be controlled on an IOP level less than 20 mmHg compared to 34% - 47% of the eyes treated with metoprolol. Metoprolol induced a transitory burning sensation in the eyes of 58% patients compared to 26% treated with timolol. Possible signs of dry eyes manifestations as measured by break-up time, rose bengal and fluorescein 1% staining, tear osmolality and Schirmer test I developed in both the timolol (4 patients) and metoprolol (3 patients) treated group. No significant influence on blood pressure and heart rate was observed. In none had the visual field or visual acuity deteriorated at the end of the study.

Aged↗
PubMed1985

Timolol and aceclidine. A clinical study of interaction in the eye.

In the Netherlands timolol maleate, probably the drug of first choice in antiglaucoma therapy, is often combined with other intraocular pressure lowering drugs. The efficacy of most combinations have been discussed in the literature several times, except the one with aceclidine, a parasympathetic drug, that has a reasonable popularity in Western Europe. Unlike pilocarpine, aceclidine does not seem to give a clinically significant additional pressure lowering effect in timolol pre-treated eyes. The decrease in IOP in aceclidine pre-treated eyes after single dose timolol seems to be an effect of timolol alone. Our results suggest that co-administration of timolol and aceclidine is not a rational action in antiglaucomatous therapy.

Aged↗
PubMed1985

A study of the efficacy of two commercial preparations of timolol maleate with special reference to side effects.

The intraocular pressure lowering effect of 2 commercial preparations of timolol maleate was studied in 57 adult outpatients suffering from open angle glaucoma or ocular hypertension. Special attention was paid to side effects of topical treatment with timolol, while comparing the efficacy of the 2 preparations. The intraocular pressure lowering effect with each strength (0.25% and 0.5%) of both preparations (Blocanol and Oftan-Timolol) was identical. No clearcut effect on lacrimal gland function, accommodation, or pupil size was seen. The adverse effects of timolol maleate during 6 months of treatment were of transient nature and generally mild. The only serious adverse effect was respiratory distress which occurred with 0.25% timolol in one patient. The respiratory distress developed slowly and the trial had to be discontinued for this patient after 2 months of treatment. There was a tendency toward a decrease in blood pressure and heart rate with both commercial preparations.

Clinical Trials as Topic↗
PubMed1992

The effect of Healon and timolol on early postoperative intraocular pressure after extracapsular cataract extraction with implantation of a posterior chamber lens.

In a prospective, randomized, masked study the effect of sodium hyaluronate (Healon) and timolol on the acute intraocular pressure rise after extracapsular cataract extraction with implantation of a posterior chamber lens were evaluated. Intraocular pressure was measured preoperatively and 3-6 h and 24 h postoperatively. When no timolol was used, a significant rise in intraocular pressure was observed at 3-6 h, whether or not Healon was aspirated. Timolol reduced the intraocular pressure rise, especially during the first 3-6 h after surgery. When timolol was not applied at the end of surgery, IOP exceeded 30 mmHg in 28% 3-6 h postoperatively, compared to only 4% when timolol was applied.

Adult↗
PubMed1993

Beta 1- and beta 2-antagonist activity of topically applied betaxolol and timolol in the systemic circulation.

The beta 1- and beta 2-antagonist activity of betaxolol and timolol in the systemic circulation was studied ex-vivo after their ocular administration in thirty patients during cataract surgery. The patients received 40 microliters of 0.5% betaxolol or 0.25% timolol into the lower cul-de-sacs of both eyes. Blood samples were collected up to four h after instillation of the doses. Plasma concentrations of betaxolol and timolol were analyzed using a radioreceptor assay. The ex-vivo-beta 1-and beta 2-receptor occupancies corresponding drug plasma levels were calculated using radioligand binding techniques. The extent of beta 1-receptor occupancy of betaxolol in the systemic circulation was less than 20% and its beta 2-receptor occupancy was negligible. The extent of beta 1-receptor occupancy of timolol was about 65% and its beta 2-receptor occupancy about 80%. Because receptor occupancy is the basis of antagonist activity of beta-blocking agents, this study shows that the beta 1-antagonist activity of betaxolol in the systemic circulation is much less than that of timolol, and that its beta 2-antagonist activity is negligible. The study suggests that the reported side effects of betaxolol in patients with obstructive pulmonary diseases are not mediated via its beta 2-receptor blocking properties.

Administration, Topical↗
PubMed1979

Management of acute closed-angle glaucoma with miotics and timolol.

The hypotensive effect of intramuscular or intravenous acetazolamide with frequent instillation of 2% or 4% pilocarpine in polyvinyl alcohol, or with single drops of pilocarpine in polyvinyl alcohol or oily vehicles, and the hypotensive effect of topical timolol alone and together with pilocarpine was investigated in the treatment of acute closed-angle glaucoma in 75 patients (81 eyes). The results showed that there was no marked difference in the hypotensive effect whether pilocarpine was used frequently or in a single dose, in different concentrations, or in different vehicles after acetazolamide. Topical timolol alone was not effective enough to control the intraocular pressure in acute closed-angle glaucoma, but a good hypotensive effect was seen when topical timolol was followed by pilocarpine. It is concluded that 1 drop of pilocarpine 3 hours after intravenous or intramuscular acetazolamide or after topical timolol may be sufficient to terminate an acute attack. Topical timolol may serve as a valuable alternative when systemic medication is contraindicated.

Acetazolamide↗
PubMed1982

Dose response of oral timolol combined with adrenaline.

Oral timolol, a beta-adrenergic receptor blocker, was given in 5 different doses from 5 mg to 30 mg a day to 12 healthy volunteers in a double-blind cross-over trial. Adrenaline was instilled into one eye in each subject. Recording of intraocular pressure during the trial suggested the presence of a dose-response relationship between the dose of timolol and the decrease of intraocular pressure. An analysis of the interaction of timolol and adrenaline showed that the adrenaline effect diminished linearly with increasing timolol dose, which finally made the combination less effective than timolol alone.

Administration, Oral↗
PubMed2004

Randomised controlled trial comparing the effect of brimonidine and timolol on visual field loss after acute primary angle closure.

AIM: To compare the effect of brimonidine and timolol in reducing visual field loss in patients with acute primary angle closure (APAC). METHODS: In addition to standard acute medical treatment, patients presenting with APAC were randomised to either brimonidine 0.2% or timolol 0.5% upon diagnosis, then twice daily for 4 weeks. After laser peripheral iridotomy (LPI), subjects underwent three baseline perimetry tests during the first week, and then at weeks 4, 8, 12, and 16. Pointwise linear regression analysis was applied to the field series of each of these subjects starting with the third test (total of five tests per subject). Progression was defined as a significant regression slope (p<0.05) showing 1 dB per year or more of sensitivity loss at the same test location in the series. Patients were also compared for prevalence of abnormal fields at 16 weeks, which was defined as an abnormal glaucoma hemifield test result and/or corrected pattern standard deviation outside the 95% confidence limits. RESULTS: 59 subjects (31 in the brimonidine group; 28 in the timolol group) completed the study. There were 47 females (79.7%), the majority of subjects (94.9%) were Chinese and the mean age was 59.2 (SD 7.2) years. There were no significant differences between the two groups with respect to demographic features, presenting intraocular pressure (IOP), duration of symptoms, time from presentation to LPI, or mean IOP at each study visit. Over the 16 week study period, despite adequate statistical power, no difference was found between groups in terms of the number of patients with progressing locations, the mean number of progressing locations per subject, or the mean slope of the progressing locations. Nine (29%) subjects in the brimonidine group and 10 (35.7%) in the timolol group were found to have significant visual field defects at 16 weeks (p = 0.58). 15 out of these 19 subjects (78.9%) already had these visual field defects in the first week. CONCLUSIONS: In the first 16 weeks after APAC, there was no difference in the prevalence of visual field defects or rate of visual field progression between brimonidine and timolol treated groups.

Acute Disease↗
PubMed1983

Influence of heart size on mortality and reinfarction in patients treated with timolol after myocardial infarction.

The influence of heart size on the effect of long term timolol treatment with regard to mortality and reinfarction after myocardial infarction was examined among 1881 patients randomised to either active or placebo treatment. The patients were followed for 12 to 33 months. At the baseline, heart size was determined by x-ray film in two projections: 1199 patients had normal heart size, 262 had borderline heart size, and 420 had enlarged hearts. The incidence of total cardiac death was three times greater in patients with enlarged hearts compared with patients with normal size hearts. The incidence of non-fatal reinfarctions, however, was independent of heart size at baseline. The timolol related reduction of total cardiac death compared with placebo was 40.7% in patients with normal heart size, 47.8% in patients with borderline heart size, and 38.2% in patients with enlarged hearts at baseline (intention to treat approach). The reduction of first non-fatal reinfarctions in the timolol group compared with placebo was, respectively, 31.7%, 41.2%, and 25.9%. Thus, timolol treatment appears to reduce cardiac death and non-fatal reinfarctions after myocardial infarction independent of heart size at baseline. Timolol treatment may be of special importance in patients with cardiomegaly, because of the very high incidence of cardiac mortality in this group of patients, and consequently a larger number of cardiac deaths may be prevented.

Cardiomegaly↗
PubMed1984

Effect of timolol maleate on pacing induced myocardial ischaemia.

The effects of timolol maleate administered intravenously on coronary and systemic haemodynamics, myocardial metabolism, and plasma catecholamine concentrations were assessed in 10 patients with confirmed coronary artery disease. Rapid atrial pacing to the onset of angina was performed in all patients. Timolol reduced cardiac output at rest and during pacing and reduced resting heart rate but did not affect arterial blood pressure. Left ventricular stroke work index fell during pacing. Coronary sinus blood flow was unchanged, but pulmonary artery diastolic pressure rose after timolol. The drug produced clinical improvement in nine of the 10 patients with prolongation of the mean pacing time to angina. There was evidence of improved myocardial metabolism with a change from production to extraction of lactate: Arterial noradrenaline concentrations at rest rose after timolol. In these patients with coronary artery disease timolol produced an increased tolerance to atrial pacing stress, which appears to be due to a combination of effects including reduced myocardial contractility and decreased lipolysis.

Angina Pectoris↗