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Travoprost for glaucoma
Advances
Ophthalmology
Page 7
once daily for the next 4 days were 19.0 mmHg, 24.7 mmHg, 24.9 mmHg, and 24.7 mmHg, respectively, and were significantly different from the control eye. After travoprost was instilled at 8 p.m., the mean baseline changes from the baseline intraocular pressure in the drug eyes were 23.5 mmHg, 24.2 mmHg, 24.5 mmHg, and 24.2 mmHg, respectively. When 0.004% travoprost was instilled twice daily, the mean baseline intraocular pressure changes were 27.7 mmHg, 28.1 mmHg, 28.4 mmHg, and 28.5 mmHg, respectively, and were significantly different from the control eyes. Miosis was frequent during the 3 studies.
Travoprost for Glaucoma Background The intraocular pressure of normal and glaucomatous dogs is reduced by several prostaglandin receptor agonists, such as latanoprost, unoprostone isopropyl, and brimatoprost. Travoprost an isomer of the prostaglandin receptor agonist, fluprostenol, which has effects similar to latanoprost. Objectives To evaluate changes in intraocular pressure and pupil size in glaucomatous dogs after instillation of 0.004% travoprost once in the morning or once in the evening, or twice daily in 5-day multiple dose studies. Procedure Applanation tonometry for measurement of intraocular pressure and pupil size measurements were obtained at 8 and 10 a.m., noon, and 2 and 4 p.m. in 8 dogs with glaucoma. A control eye was treated topically with 0.5% methylcellulose, and the other eye was instilled with 0.004% travoprost. The first day was used for baseline measurements. Both eyes were treated on the second through to the fifth day with instillations in the morning (8:30 a.m.), or evening (8 p.m.), or twice daily (8:30 a.m. and 8 p.m.). Two weeks of washout were provided prior to changes in treatment. Results The mean diurnal changes from baseline intraocular pressure in the control and placebo eyes in all three studies ranged from 1.2 to 3.2 mmHg. The mean diurnal changes from the baseline intraocular pressure after 0.004% travoprost at 8 a.m.
Author Conclusion Travoprost instilled in the eye once daily or twice daily produces significant decreases in intraocular pressure and pupil size in the glaucomatous dogs. Inclusions Three figures, 39 references. Editor Annotation Canine glaucoma remains one of the most common causes of blindness in dogs and
is also a difficult disease to treat effectively, especially in dogs with primary glaucoma. Maintenance of long-term vision requires surgical intervention with a laser, cyclophotoablation of the ciliary body, or an aqueous shunting device such as a valved frontal sinus shunt. Although we know that medical therapy will eventually fail, medical therapy remains an integral part of management of this disease. For the past 10 to 15 years, topical prostaglandins have been studied and used in both humans and dogs to treat glaucoma. These drugs have been shown to have profound intraocular pressure lowering effects in dogs. Anti-glaucoma medications have consistently demonstrated an increased effect in glaucomatous dogs when compared to normal dogs. This study evaluated dogs with primary glaucoma in both single dose and twicedaily dose schedules. The twice-daily dose schedule had more uniform intraocular pressure reductions and daily fluctuations or spikes were of limited magnitude or absent. For a clinician, the most dramatic result was that the magnitude of the intraocular reduction on the twice daily dose schedule was 28 mm Hg. Even the single
Page 8
dose schedule reduced intraocular pressure by 19 to 25 mm Hg. It appears that travoprost will make an excellent addition to the medical management of canine glaucoma. (REH) Gelatt KN and MacKay EO. Effect of different dose schedules of travoprost on intraocular pressure and pupil size in the glaucomatous beagle. Vet Ophthalmol 2004;7:53-57.
Advances
Ophthalmology
Page 7
once daily for the next 4 days were 19.0 mmHg, 24.7 mmHg, 24.9 mmHg, and 24.7 mmHg, respectively, and were significantly different from the control eye. After travoprost was instilled at 8 p.m., the mean baseline changes from the baseline intraocular pressure in the drug eyes were 23.5 mmHg, 24.2 mmHg, 24.5 mmHg, and 24.2 mmHg, respectively. When 0.004% travoprost was instilled twice daily, the mean baseline intraocular pressure changes were 27.7 mmHg, 28.1 mmHg, 28.4 mmHg, and 28.5 mmHg, respectively, and were significantly different from the control eyes. Miosis was frequent during the 3 studies.
Travoprost for Glaucoma Background The intraocular pressure of normal and glaucomatous dogs is reduced by several prostaglandin receptor agonists, such as latanoprost, unoprostone isopropyl, and brimatoprost. Travoprost an isomer of the prostaglandin receptor agonist, fluprostenol, which has effects similar to latanoprost. Objectives To evaluate changes in intraocular pressure and pupil size in glaucomatous dogs after instillation of 0.004% travoprost once in the morning or once in the evening, or twice daily in 5-day multiple dose studies. Procedure Applanation tonometry for measurement of intraocular pressure and pupil size measurements were obtained at 8 and 10 a.m., noon, and 2 and 4 p.m. in 8 dogs with glaucoma. A control eye was treated topically with 0.5% methylcellulose, and the other eye was instilled with 0.004% travoprost. The first day was used for baseline measurements. Both eyes were treated on the second through to the fifth day with instillations in the morning (8:30 a.m.), or evening (8 p.m.), or twice daily (8:30 a.m. and 8 p.m.). Two weeks of washout were provided prior to changes in treatment. Results The mean diurnal changes from baseline intraocular pressure in the control and placebo eyes in all three studies ranged from 1.2 to 3.2 mmHg. The mean diurnal changes from the baseline intraocular pressure after 0.004% travoprost at 8 a.m.
Author Conclusion Travoprost instilled in the eye once daily or twice daily produces significant decreases in intraocular pressure and pupil size in the glaucomatous dogs. Inclusions Three figures, 39 references. Editor Annotation Canine glaucoma remains one of the most common causes of blindness in dogs and
is also a difficult disease to treat effectively, especially in dogs with primary glaucoma. Maintenance of long-term vision requires surgical intervention with a laser, cyclophotoablation of the ciliary body, or an aqueous shunting device such as a valved frontal sinus shunt. Although we know that medical therapy will eventually fail, medical therapy remains an integral part of management of this disease. For the past 10 to 15 years, topical prostaglandins have been studied and used in both humans and dogs to treat glaucoma. These drugs have been shown to have profound intraocular pressure lowering effects in dogs. Anti-glaucoma medications have consistently demonstrated an increased effect in glaucomatous dogs when compared to normal dogs. This study evaluated dogs with primary glaucoma in both single dose and twicedaily dose schedules. The twice-daily dose schedule had more uniform intraocular pressure reductions and daily fluctuations or spikes were of limited magnitude or absent. For a clinician, the most dramatic result was that the magnitude of the intraocular reduction on the twice daily dose schedule was 28 mm Hg. Even the single
Page 8
dose schedule reduced intraocular pressure by 19 to 25 mm Hg. It appears that travoprost will make an excellent addition to the medical management of canine glaucoma. (REH) Gelatt KN and MacKay EO. Effect of different dose schedules of travoprost on intraocular pressure and pupil size in the glaucomatous beagle. Vet Ophthalmol 2004;7:53-57.
Advances