Prempal Kaur1, Vishal Brar2, Bhavkaran Singh Bal3, Inderjit Kaur4
Glaucoma is the leading cause of irreversible blindness in the world as it can remain asymptomatic until it causes severe visual loss. The target intraocular pressure with which progression is slowed sufficiently to avoid functional impairment should be achieved with the fewest medications and minimum adverse effects. The choice of medicine may be influenced by efficacy, cost, adverse effects, and dosing schedules. In general, prostaglandin analogues (PGA) are the first-line of medical therapy. These drugs are administered once at night and have few systemic adverse effects. The study was conducted to compare the efficacy and safety of available PGAs.
MATERIAL AND METHODS
The study was conducted on sixty diagnosed cases of primary open angle glaucoma visiting the Outpatient Department of Regional Institute of Ophthalmology, Government Medical College, Amritsar. They were divided into three groups of twenty each. Each group was put on either of these anti-glaucoma topical drug (PGA - latanoprost 0.005%, travoprost 0.004% and bimatoprost 0.03%) for three months duration. IOP at 9:00 AM ± 1 hr. and 4:00 PM ± 1 hr. were taken before and after 1 month and 3 months of treatment. The results of the reduction in mean IOP in each group were compared and analysed.
Mean baseline IOP at 8 AM in each group was similar (p value 0.772). Average decrease in IOP between the pretreatment (Baseline IOP) and post-treatment levels (i.e. at 3 months) was 31.90% in Group 1 (Bimatoprost Group), 32.97% in Group 2 (Latanoprost Group) and 34.75% in Group 3 (Travoprost Group). When we applied paired t test, in each group, p value was <0.001, showing a statistically significant change. Once the efficacy of drugs was seen, we compared the efficacy of 3 groups with each other by applying ANOVA, P value was 0.108 which is not statistically significant.
Individually Bimatoprost, Latanoprost and Travoprost significantly lowered the intraocular pressure but this reduction was not statistically significant when compared amongst themselves. All these three PGAs are quite safe drugs with no serious adverse events reported during our study. Conjunctival hyperaemia was the most common side effect followed by itching, burning and stinging sensation. Latanoprost exhibited the lowest incidence of adverse effects whereas Bimatoprost and Travoprost were similar in their tendency to cause these.