Objective To evaluate the intraocular pressure (IOP) reduction achieved by the most frequently prescribed antiglaucoma drugs in patients with normal tension glaucoma (NTG).
Design Meta-analysis of randomized clinical trials.
Participants Fourteen randomized clinical trials reported 23 arms for peak, 14 arms for trough, and 11 arms for diurnal curve.
Methods Pertinent publications were identified through systematic searches of PubMed, EMBASE, Chinese Biomedicine Database, and the Cochrane Controlled Trials Register. The patients had to be diagnosed with NTG. Methodological quality was assessed by aDelphilist with additions and scored out of a maximum of eighteen. The pooled 1-month IOP-lowering effects were calculated using two-step DerSimonian and Laird estimate method of the random effects model.
Main Outcome Measures Absolute and relative reduction in IOP from baseline, for peak, trough, and diurnal curve.
Results: Quality scores of included studies were generally high, a mean of 12.6 ranged from 9 to 16. Relative IOP reduction were 12% (95% confidence interval, 1% to 23%) for a peak for betaxlol; peak, 15% (12% to 17%), trough, 18% (8% to 27%), and diurnal curve, 17% (8% to 25%) for timolol; peak, 14% (8% to 19%), and trough, 12% (-7% to 31%) for dorzolamide; 13% (6% to 20%) for a peak for brinzolamide; peak, 24% (17% to 31%), trough, 11% (7% to 14%), and diurnal curve, 16% (12% to 20%) for brimonidine; peak, 21% (17% to 25%), trough, 21% (18% to 23%), and diurnal curve, 21% (17% to 24%) for latanoprost; peak, 21% (10% to 31%), trough, 18% (11% to 26%), and diurnal curve, 20% (13% to 27%) for bimatoprost. The difference in absolute IOP reduction between prostaglandin analogues and timolol varied from 0.9 to 1.2 mmHg at peak, -0.1 to 0.4 mmHg at trough and 0.5 to 0.6 mmHg at diurnal curve.
Conclusions Latanoprost, bimatoprost, and timolol are the most effective IOP-reducing agents in NTG patients. |
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