Comparison of the efficacy of latanoprost versus dorzolamide/timolol fixed combination therapy in patients with pseudoexfoliative glaucoma according to glaucoma stage / Comparação da eficácia da terapia de combinação fixa latanoprosta versus dorzolamida/timolol em pacientes com glaucoma pseudoesfoliativo de acordo com o estágio de glaucoma

ABSTRACT Purpose: Only a few trials have compared the intraocular pressure-lowering effects of prostaglandin analogs to carbonic anhydrase inhibitor plus beta-blocker fixed-dose combination therapy in patients with pseudoexfoliative glaucoma. Furthermore, the influence of the glaucoma stage on the intraocular pressure-lowering effects of these drug types has not been studied. The purpose of this study was to compare the IOP-lowering efficacy of latanoprost, a prostaglandin analog versus dorzolamide/timolol fixed combination, a carbonic anhydrase inhibitor plus beta-blocker fixed-dose combination therapy, in patients with pseudoexfoliative glaucoma based on glaucoma stage. Methods: The data of 32 eyes (32 patients) diagnosed with uniocular pseudoexfoliative glaucoma and treated with topical latanoprost (Group 1) or dorzolamide/timolol fixed combination (Group 2) were retrospectively assessed. The groups were subdivided into early and moderate-advanced stages. Patients' demographics, baseline intraocular pressure, final intraocular pressure, and intraocular pressure difference (the difference between the baseline and final intraocular pressure) were determined from medical records and compared between groups and according to glaucoma stage. Results: The mean drug use duration was 17.7 ± 13.5 months. No significant differences in mean baseline intraocular pressure, mean final intraocular pressure and mean intraocular pressure difference between Groups 1 and 2. In Group 2, the mean intraocular pressure difference was significantly greater in patients with early versus moderate-advanced stage glaucoma (p=0.015). The difference, however, was not detected in Group 1. The mean intraocular pressure difference in early-stage glaucoma was significantly greater in Group 2 versus 1 (p=0.033). Conclusions: Latanoprost and dorzolamide/timolol fixed combination are effective treatments for newly diagnosed pseudoexfoliative glaucoma. In early-stage pseudoexfoliative glaucoma, greater intraocular pressure reduction was noted with dorzolamide/timolol fixed combination than with latanoprost; thus, dorzolamide/timolol fixed combination should be considered when a significant decrease in intraocular pressure is desired in early-stage glaucoma.

RESUMO Objetivo: Estudos limitados examinaram os efeitos de redução de pressão intraocular de análogos de prostaglandina versus inibidor de anidrase carbônica mais terapia de combinação de dose fixa beta-bloqueador em pacientes com glaucoma pseudoesfoliativo. Além disso, a influência do estágio de glaucoma nos efeitos de redução da pressão intraocular desses tipos de drogas não foi avaliada. Este estudo teve como objetivo comparar a eficácia de redução do IOP do latanoprosta, uma combinação fixa análoga de prostaglandina versus dorzolamida/timolol, um inibidor de anidrase carbônica mais terapia de combinação de dose fixa beta-bloqueador, em pacientes com glaucoma pseudoesfoliativo de acordo com o estágio de glaucoma. Métodos: Os dados de 32 olhos (32 pacientes) diagnosticados com glaucoma pseudoesfoliativo monocular e tratados com latanoprosta tópica (Grupo 1) ou combinação fixa de dorzolamida/timolol (Grupo 2) foram avaliados retrospectivamente. Os grupos foram subdivididos em estágios inicial e moderado-avançado. A demografia dos pacientes, a pressão intraocular da linha de base, a pressão intraocular final e a diferença de pressão intraocular (a diferença entre a pressão intraocular da linha de base e a pressão intraocular final) foram determinadas a partir dos prontuários médicos e comparadas entre os dois grupos e de acordo com o estágio de glaucoma. Resultados: A duração média do uso de drogas foi de 17,7 ± 13,5 meses. Nenhuma diferença significativa foi observada entre os grupos 1 e 2 para a média da pressão intraocularda linha de base, média da pressão intraocular final e média da diferença da pressão intraocular. No Grupo 2, a média da diferença da pressão intraocular foi significativamente maior em pacientes com glaucoma de estágio precoce versus moderado-avançado (p=0,015). No entanto, essa diferença não foi observada no Grupo 1. A média da diferença da pressão intraocular em glaucoma de estágio inicial foi significativamente maior no Grupo 2 versus 1 (p=0,033). Conclusões: Terapias com Latanoprosta e dorzolamida/timolol são tratamentos eficazes para glaucoma pseudoesfoliativo recém-diagnosticado. Observou-se em glaucoma pseudoesfoliativo de estágio inicial, uma maior redução da pressão intraocular com combinação fixa de dorzolamida/timolol do que com latanoprosta; assim, a combinação fixa de dorzolamida/timolol deve ser considerada quando uma diminuição significativa da pressão intraocular é almejada em glaucoma de estágio inicial.

Effectiveness and safety of 0.5% timolol solution in the treatment of pyogenic granuloma: A randomized, double-blind and placebo-controlled study

Introduction: Pyogenic granulomas are benign vascular lesions of the skin and mucosa which are often a source of concern because of their recurrent bleeding even with minimal trauma. Current treatment for pyogenic granuloma is ablative; no medical therapy is standardized to date. Timolol, due to its vasoconstrictive effect, vascular growth factor inhibition and apoptosis promotion properties, is a potential therapeutic option. Objectives: To assess the effectiveness and safety of topical timolol in the treatment of pyogenic granulomas. Methods: A two-centre, double-blind and placebo-controlled trial (Registration CTRI/2019/04/018581) was conducted. Patients of either sex were recruited with pyogenic granuloma lesions of less than eight weeks duration. Topical treatment with 0.5% timolol or matching glycerin placebo was continued for six weeks. Changes in color, size, bleeding tendency, physicians’ and patients’ global assessments and adverse events were assessed. Results: Forty subjects were randomized between the two groups which were comparable in age, sex, duration of illness and baseline lesion size.Significant improvement was noted with timolol, with color change from first follow-up onwards and lesion size reduction from second follow-up onward. Patients’ assessment of bleeding tendency also showed imrovement from the second visit onward. Between-group comparison showed significant difference with respect to percentage reduction in size (timolol 40.9%, placebo 3.4%; P = 0.002). Rescue treatment (electrosurgery) was required in five patients on placebo and in one in the timolol group (P = 0.182). Complete resolution occurred in 2 (10%) patients with timolol and in no patients on placebo (P = 0.231). Limitations: We observed effects of treatment for only six weeks. Conclusion: Topical timolol may be a treatment option for early pyogenic granulomas but complete resolution is unlikely in six weeks. Studies of longer duration are required to assess resolution and recurrence rates

Comparison of the efficacy and safety of topical timolol and oral propranolol for the treatment of Superficial Infantile Haemangiomas

Background: Infantile haemangiomas (IHs) are the most common vascular tumours of infancy. In recenttime oral propranolol has achieved great success in treating IHs. To minimize the systemic side events caused by oral propranolol, topical timolol started to be applied in the treatment of IHs, especially for superficial lesions. Methods: We treated 50 children with superficial IHs using oral propranolol on 25 patients and, topical timolol on 25 patients and investigated the efficacy and safety of the two treatment patterns. Results: Both oral propranolol and topical timolol achieved a satisfactory therapeutic outcome, with an effective response rate of 96 and 95.4%, respectively. No significant differences in visual analogy scale (VAS) improvement between the two groups were observed. Systemic adverse events for patients treated with oral propranolol (3.9%) was significantly higher than that for patients treated with topical timolol. Clinical response was not associated with gender, duration of treatment, lesion location, lesion size, and gestational age but closely associated with age at treatment initiation, which indicated that younger age at treatment initiation predicted for a better regression rate. Conclusion: Topical timolol could be the first-line therapy for superficial IHs because of its good efficacy and improved safety profile.

A comparative study of timolol plus either brimonidine (0.2%) or dorzolamide (2%) or latanoprost (0.005%) dual therapy in suboptimal responders to timolol (0.5%) monotherapy among patients of open-angle glaucoma, ocular hypertension and normal-tension glaucoma

Background: Studies comparing the efficacy and tolerability of the three fixed combinations of timolol with its monotherapy are not readily available. In this background, the current prospective observational study was planned. Aim and Objective: To evaluate and compare the intraocular pressure (IOP) reduction, change in visual field, and cup-disc ratio in glaucoma patients receiving timolol monotherapy vis-a-vis timolol based dual therapies among timolol sub-optimal responders. Materials and Methods: After obtaining written informed consent and fulfilling the inclusion-exclusion criteria, fifty consecutive newly diagnosed cases of glaucoma or ocular hypertension with risk factors were recruited in the study. They received timolol eye drop up to 4th week. Participants not responding to timolol monotherapy optimally received either timolol plus brimonidine or timolol plus dorzolamide or timolol plus latanoprost for another 12 weeks. Participants responding optimally (at least 30% reduction of baseline) were continued with timolol monotherapy. Besides IOP changes, effects on visual field, visual acuity, cup disc ratio, safety, tolerability, and rate of persistency to therapy were studied. Results: Fifteen participants (30%) achieved target IOP reduction at 4 weeks of timolol monotherapy. All four treatment groups achieved significant IOP reduction (P < 0.001) from baseline to 16th week. Participants receiving timolol followed by timolol plus latanoprost had shown the highest IOP reduction at 16th week both from baseline and 4th week value (ANOVA test, P = 0.027, P = 0.000 respectively). No change in visual field or visual acuity or cup disc ratio was noticed. Adverse drug reactions observed were mild and mostly self limiting. Conclusion: Timolol and latanoprost combination might be a better choice in sub-optimal responders to timolol whereas it is wise to continue timolol monotherapy in optimally responders.

Meta-analysis of efficacy between Travoprost and Timolol in treating primary open angle glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To systematically evaluate the changes of hemodynamics, astigmatism and cytokines between travoprost and timolol in the treatment of primary open angle glaucoma(POAG)in Chinese adults.METHODS:Randomized controlled trials(RCTs)and cohort studies comparing the related efficacy of travoprost and timolol for POAG were retrieved from PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure(CNKI), Chinese Biomedical Literature Database(CBM), VIP database and Wanfang database. The search time was from January 1, 2015 to December 31, 2020. The literatures were screened according to the inclusion and exclusion criteria. After quality evaluation by Cochrane tools for RCTs and NOS scores for cohort studies, Review Manager 5.4 software was used for Meta-analyses to generate weighed-mean-difference(<i>WMD</i>)as effect size contrasting the efficacy of travoprost and timolol for the peak systolic velocity(PSV), the end diastolic velocity(EDV)and the resistance index(RI)of the central retinal artery(CRA)and the posterior ciliary artery(PCA), astigmatism, the plasma endothelin-1(ET-1), the serum matrix metalloproteinase(MMP), the tissue inhibitor of metalloproteinase-2(TIMP-2)of the aqueous humor and the serum TIMP-2. RESULTS:Totally 8 RCTs and 4 retrospective cohort studies were included with 1 192 patients.Meta-analysis showed that:compared with timolol group, the travoprost group had greater effect on increasing the PSV(<i>WMD</i>=2.40, 95%<i>CI</i>: 2.12-2.68, <i>P</i><0.00001; <i>WMD</i>=3.76, 95%<i>CI</i>: 3.30-4.22, <i>P</i><0.00001)and the EDV(<i>WMD</i>=0.81, 95%<i>CI</i>: 0.70-0.91, <i>P</i><0.00001; <i>WMD</i>=0.90, 95%<i>CI</i>: 0.72-1.09, <i>P</i><0.00001)of the CRA and the PCA as well as on decreasing the RI(<i>WMD</i>=-0.07, 95%<i>CI</i>: -0.10 to -0.04, <i>P</i><0.00001; <i>WMD</i>=-0.07, 95%<i>CI</i>: -0.08 to -0.05, <i>P</i><0.00001)of the CRA and the PCA; Travoprost was more effective in decreasing astigmatism(<i>WMD</i>=-1.34, 95%<i>CI</i>: -1.62 to -1.06, <i>P</i><0.00001); Compared with timolol, travoprost could significantly decrease the plasma ET-1(<i>WMD</i>=-5.14, 95%<i>CI</i>: -7.08 to -3.20, <i>P</i><0.00001)and the serum MMP(<i>WMD</i>=-12.48, 95%<i>CI</i>: -24.27 to -0.69, <i>P</i>=0.04), while no statistically significant differences were found in the TIMP-2 of the aqueous humor(<i>WMD</i>=-1.40, 95%<i>CI</i>: -5.51-2.71, <i>P</i>=0.51)and the serum TIMP-2(<i>WMD</i>=1.69, 95%<i>CI</i>: -30.03-33.41, <i>P</i>=0.92).CONCLUSION:Compared with timolol, travoprost was more effective in improving hemodynamic indexes and decreasing astigmatism in the treatment of POAG.

The Yijing Buyang Huanwu Decoction combined with timolol maleate in the treatment of POAG / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To discuss the effect of Yijing Buyang Huanwu Decoction combined with timolol maleate eye drop on the blood supply and intraocular pressure in patients with primary open angle glaucoma(POAG). <p>METHODS:The 120 patients with POAG in our hospital from February 2018 to February 2020 were selected, they were divided into decoction group(<i>n</i>=60)and eye drop group(<i>n</i>=60)according to the randomly table. The eye drop group was treated with timolol maleate eye drop, and the decoction group was treated with Yijing Buyang Huanwu Decoction on the basis of the eye drop group, the eye blood supply \〖end diastolic velocity(EDV), peak systolic velocity(PSA), resistance index(RI)of central retinal artery(CRA)and posterior ciliary artery(PCA)\〗, intraocular pressure, visual acuity, visual field \〖mean sensitivity(MS), mean deviation(MD)\〗, efficacy and adverse reactions were compared between the two groups. <p>RESULTS: The EDV and PSA of the CRA and PCA and the visual acuity, MS in the Decoction group and eye drop group after treatment were significantly higher than those in the before treatment, the RI of the CRA and PCA and the intraocular pressure, MD in the Decoction group and eye drop group after treatment were significantly lower than those in the before treatment, the EDV and PSA of the CRA and PCA and the visual acuity, MS in the Decoction group after treatment were significantly higher than those in the eye drop group, the RI of the CRA and PCA and the intraocular pressure, MD in the Decoction group after treatment were significantly lower than those in the eye drop group(<i>P</i><0.05). The effective rate in the Decoction group was significantly higher than that in eye drop group(<i>P</i><0.05). There was no significant difference in adverse reactions between the Decoction group and eye drop group(<i>P</i>>0.05).<p>CONCLUSION: Yijing Buyang Huanwu Decoction combined with timolol maleate eye drop can effectively improve the blood supply, intraocular pressure and visual acuity, visual field of patients with POAG, it can improve the efficacy, and it has the good safety, it's worth for further clinical promotion.

Comparative evaluation of Latanoprostene Bunod, Timolol Maleate, and latanoprost Ophthalmic Solutions to assess their safety and efficacy in lowering intraocular pressure for the management of Open-Angle Glaucoma

OBJECTIVES: Timolol maleate has been reported to be a safer intraocular pressure (IOP) lowering treatment than latanoprost. The United States Food and Drug Administration approved latanoprostene bunod, a nitric oxide-donating prodrug of latanoprost, for lowering IOP. This study compared the safety and efficacy of latanoprost, latanoprostene bunod, and timolol maleate in patients with open-angle glaucoma. METHODS: Patients who received latanoprost eye drops once daily in the evening were included in the latanoprost Ophthalmic Solutions (LP) cohort (n=104). Those who received latanoprostene bunod eye drops once daily in the evening were included in the Latanoprostene Bunod (LB) cohort (n=94). Those who received timolol eye drops twice daily were included in the Timolol Maleate (TM) cohort (n=115). All treatments were administered to the affected eye(s) for 3 months. Informed Consent has been taken from each participant before the trial. RESULTS: At the end of 3 months of treatment, latanoprost, latanoprostene bunod, and timolol were all successful in reducing IOP. The LB cohort had the highest reduction in IOP, compared to the LP and TM cohorts. All treatments had some common adverse ocular effects. CONCLUSION: Latanoprostene bunod was superior to latanoprost and timolol for the treatment of open-angle glaucoma.

Hemangioma infantil: actualización del tratamiento tópico y sistémico / Infantile hemangioma: an update in the topical and systemic treatments

Resumen Los hemagiomas infantiles (HI) son los tumores de tejidos blandos más frecuentes de la infancia. Se caracterizan por un crecimiento significativo durante los primeros meses de vida, seguido de una involución lenta y espontánea a lo largo de un periodo que puede durar algunos años. Usualmente, la regresión de la mayor parte del tumor termina a los 4 años de edad. Sin embargo, algunos de los HI desarrollan complicaciones, lo que resulta en alteraciones funcionales, dolor y desfiguramiento. La decisión de administrar tratamiento a un paciente con HI y elegir la mejor opción terapéutica para ese paciente (tratamiento tópico o sistémico) debe ser individualizada, dependiendo de varios factores: el tamaño de la lesión, la localización, la presencia de complicaciones como ulceración, el riesgo de cicatrización o desfiguramiento, la edad del paciente, la tasa de crecimiento o de involución al momento del diagnóstico, los riesgos y beneficios de administrar el tratamiento, la disponibilidad del medicamento, los costos y la experiencia del médico tratante.

Abstract Infantile hemagiomas (IH) are the most common soft tissue tumors in infancy. They are characterized by significant growth during the first months of life, followed by slow spontaneous involution over the ensuring years. The process of involution takes several years, but usually the regression of most of the tumors ends at 4 years of age. Unfortunately, some of the IH develop complications, resulting in functional impairment, pain and disfigurement. The decision to start treatment and the choice of the best therapeutic option (topic or systemic) should be individualized depending on several factors: the size of the lesion, the location, the presence of complications such as ulceration, the risk of scarring or disfigurement, the age of the patient, the rate of growth or regression at the time of diagnosis, the risks and benefits of the treatment, the availability of the medication, the costs, and the experience of the attending physician.

Antimicrobial effectiveness of domestic timolol maleate eye drops / 中国药学杂志

OBJECTIVE: To screen out suitable antibacterial agent and reasonable dosage for timolol maleate eye drops. METHODS: According to the method of bacteriostatic effect test in Chinese Pharmacopoeia (Ch.P) 2015, the antimicrobial effectiveness of antimicrobial preservatives at different concentrations was tested to screen out the optimal agent and dosage. RESULTS: The eye drops added with ethyl hydroxybenzoate met the B-level requirements of bacteriostatic efficacy, which was the same as the sample without antibacterial agent, so ethyl hydroxybenzoate was not suitable as the antimicrobial preservative. The growth of five kinds of test microorganisms was inhibited effectively by 0.03 mg·mL-1 benzalkonium bromide. The timolol maleate eye drops with 0.03 mg·mL-1 benzalkonium bromide met the requirement of the quality standard. CONCLUSION: Benzalkonium bromide can be used as the antimicrobial preservative for timolol maleate eye drops.

Comparison of oral propranolol alone and combined with topical 0.5% timolol maleate cream for the treatment of infantile hemangiomas / 中华整形外科杂志

Objective@#To investigate whether the combination of oral propranolol and topical 0.5% timolol maleate cream is more effective than oral propranolol alone for treating infantile hemangioma (IH).@*Methods@#From September 2015 to July 2016, 14 patients with proliferative IH, visited the infantile hemangioma outpatient clinic of the Department of Plastic and Reconstructive Surgery of Shanghai 9th People′s Hospital, were enrolled in this study. All patients took oral propranolol. Half of each IH lesion was treated with 0.5% timolol maleate cream. There were 5 male patients and 9 female patients, aged from 1.5 to 5.0 months. After 4 months of treatment, the color, size, extent, volume and the overall clinical outcomes of each lesion were measured, and the side effects were recorded. The therapeutic outcomes of oral propranolol alone and the combination of propranolol and timolol were analyzed and compared using Wilcoxon matched-pair signed-rank nonparametric tests.@*Results@#Both oral propranolol alone and oral propranolol combined with topical 0.5% timolol maleate cream were proved to effectively improve the regression of IH with minor side effects. The color VAS score of oral propranolol alone group was 6.92±2.63, while the combination group was 6.88±2.33 (Z=0.043, P=0.966). The volume VAS score of oral propranolol alone group was 6.94±2.00, while the combination group was 6.98±2.11(Z=-0.051, P=0.959).@*Conclusions@#Oral propranolol combined with topical application of 0.5% timolol maleate could not increase the efficacy in the treatment of IH, compared with oral propranolol alone in the short-term observation.

Effect of timolol on refractive regression after high myopia surgery at different time points in LASIK operation / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To observe the effect of timolol on refractive regression after high myopia surgery at different time points in LASIK operation.<p>METHODS: Prospective study. Totally 180 eyes of 90 patients with high myopia who were admitted to our hospital from August 2015 to August 2016 were randomly divided into control group and observation group. Each group had 45 cases and 90 eyes. Both groups were treated with loxacin eye drops and tobramycin dexamethasone eye drops for 1wk. The control group was treated with timolol eye drops 7d after operation, and the observation group was treated with timolol eye drops 1d after operation. The uncorrected visual acuity, spherical equivalent, intraocular pressure, corneal surface curvature and corneal stroma thickness were measured and compared before and 7d, 1, 3 and 6mo after operation.<p>RESULTS: There were differences in naked vision and spherical equivalent between the two groups at different time points after operation(<i>P</i><0.05). At 6mo after operation, the naked vision and spherical equivalent of the observation group were better than those of the control group(0.03±0.01 <i>vs</i> 0.08±0.01; 0.15±0.33D <i>vs</i> -0.17±0.36D; all <i>P</i><0.05). There was no difference in corneal stroma thickness and corneal surface curvature between the two groups at different time points(<i>P</i>>0.05). The intraocular pressure of the observation group was significantly lower than that of the control group at 7d, 1 and 3mo after operation(all <i>P</i><0.05). The intraocular pressure of the two groups tended to be stable at 6mo after operation.<p>CONCLUSION: Early application of timolol after LASIK can effectively reduce intraocular pressure, maintain relatively long-term stability of intraocular pressure, prevent corneal swelling, and thus prevent refractive regression.

Clinical study of Fuming tablet combined with Timolol Maleate eye drops in the treatment of open angle glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the clinical study of Fuming tablet combined with timolol maleate eye drops in the treatment of open angle glaucoma.<p>METHODS: Totally 82(147 eyes)patients with open angle glaucoma who were treated in our hospital from April 2017 to July 2018 were selected as the research objects. According to the treatment methods, they were divided into control group and observation group, 41 cases in each group. Patients in the control group(72 eyes)were treated with timolol lecitrate eye drops, while patients in the observation group(75 eyes)were treated with Fuming tablets on the basis of the control group. The clinical efficacy of the two groups was observed. The intraocular pressure and hemorheology of the patients in the two groups were compared and analyzed before and after treatment.<p>RESULTS: After 12wk treatment, there was a significant difference in the total clinical effective rate(94.7% <i>vs</i> 80.6%)between the observation group and the control group(<i>P</i><0.05). And the intraocular pressure of both groups was significantly lower than that before and after 6wk of treatment(<i>P</i><0.05), and the intraocular pressure of the observation group was significantly lower than that of the control group(<i>P</i><0.05). The levels of PSV, EDV and RI in the control group were not significantly different from those before treatment(<i>P</i>>0.05); while the levels of PSV and EDV in the observation group were significantly higher than those before treatment(<i>P</i><0.05), and the levels of RI were significantly lower than those before treatment(<i>P</i><0.05). And there were significant differences in the levels of PSV, EDV and RI between two groups(<i>P</i><0.05). There was no significant difference in the total incidence of adverse reactions between two groups during the treatment(<i>P</i>>0.05).<p>CONCLUSION:Fuming tablet combined with timolol maleate eye drops can effectively improve the clinical efficacy of patients with open angle glaucoma. The effect of lowering intraocular pressure is obvious. At the same time, it has a good effect on the ocular hemorheology of patients with open angle glaucoma. This is a safe and reliable clinical treatment of open angle glaucoma.

Study of the therapeutic effect of oral propranolol combined with topical timolol maleate in the treatment of mixed maxillofacial hemangioma in infants / 口腔疾病防治

Objective@#To observe the treatment effect of oral propranolol combined with topical timolol maleate for infantile maxillofacial mixed hemangioma and provide evidence for clinical treatment.@*Methods@# Ninety-seven cases of infantile maxillofacial mixed hemangioma were enrolled. The cases were randomly divided into A and B groups: 50 cases in group A were treated with oral propranolol combined with topical timolol maleate, and 47 cases in group B were treated with oral propranolol only. The changes in the color, volume, and texture of the tumors were recorded before and after treatment, and color ultrasonography of the lesion area was performed. The follow-up time was 1-12 months. The differences in the curative effect, effective time and adverse reaction between the two groups were compared. @*Results @#The effective rate of group A was 92.0% (46/50) and that of group B was 74.5% (35/47), with a statistical significance (P < 0.05). The mean time of treatment in group A was 4.2 months and that in group B was 5.5 months. Compared with group B, the treatment time of group B was shorter (t=3.211, P < 0.05), and no serious adverse reactions occurred in both groups.@*Conclusion@#Oral propranolol combined with topical timolol maleate is effective in the treatment of mixed hemangioma of the maxillofacial region in infants.

Study of prescription pattern of antiglaucoma drugs used in treatment of primary open angle glaucoma in ophthalmology outpatient department of a tertiary care hospital

Background: In view of the high prevalence rates and the fact that medication is the primary line of treatment in POAG, an understanding of prescribing patterns can provide an insight into rational use of antiglaucoma drugs.Methods: This prospective, cross-sectional study was conducted in the glaucoma clinic of a tertiary care teaching hospital over a period of 12 months. Data from prescriptions of patients with POAG was recorded to study the prescribing pattern of antiglaucoma medications, completeness of the prescription and analysis of the prescriber’s influence.Results: Total of 103 prescriptions were included in which all the 141 anti-glaucoma drugs were prescribed as eye drops. Average number of drugs prescribed in present study was 1.36. ? blockers, particularly Timolol (58%) was the most frequently prescribed drug. Timolol with dorzolamide (15%) was the only prescribed fixed dose combination. Prostaglandin analogues (5%) were least commonly prescribed. 53% drugs were prescribed by generic names and 43% were prescribed from hospital formulary. Instructions regarding the route and frequency of drug administration with duration of treatment were present in all prescriptions; however, instructions regarding method of instillation of eye drops were missing. Authors observed prescriber’s influence in present study.Conclusions: Overall prescribing pattern in our set up is satisfactory. There is a need to sensitize the prescribers regarding the importance of writing method of instillation in prescription as this could improve efficacy reduce side effects, prevent drug wastage and reduce cost. To encourage the physicians for rational prescribing such type of studies should be done more often for periodic auditing of prescriptions.

A Comparative Study Of Topical Betaxalol And Timolol For Their Efficacy And Side Effects

Purpose:Primary open angle glaucoma (POAG) is one such field in Ophthalmology where ophthalmologists have failed to stop blindness due to it. All the available treatment modalities are directed towards the reduction of intra-ocular pressure (IOP) but without interfering the basic aetiopathogenesis. In this study we propose to study efficacy, potency and adverse effects of topical Timolol and Betaxalol in primary open angle glaucoma. Methodology:A com-parative study of topical Betaxalol 0.5% and Timolol 0.5% in the management of POAG was conducted at Tertiary care hospital. Fifty patients of newly diagnosed POAG of different age, sex, religion from both urban and rural popu-lation attending eye OPD were included in this study.25 patients were treated with topical Timolol maleate 0.5% ophthalmic solution BD and 25 patients were treated with topical 0.5% Betaxalol hydrochloride phthalmic solution BD. At 20 weeks follow up IOP levels n both the groups measured by applanation tonometer were compare to each other. Results:In this study a total of 50 patients with POAG were studied. 25 patients were treated with Timolol maleate 0.5% ophthalmic solution and 25 patients were treated with 0.5% Betaxalol hydrochloride ophthalmic solu-tion. Out of 50 patients, 29 (58%) were male and 21(42%) were female patients. POAG was most common in the age group of 51-60 years with average age 51.50 (S.D. 9.8) years. Average age in males was 54.50 years, while in female it was 49.31 years. Conclusion: both Timolol and Betaxalol are effective in decreasing IOP in POAG patients. The mag-nitude of Timolol in decreasing IOP is more as compared to Betaxalol. The selective beta 1 adrenergic inhibition of Betaxalol provides an added benefit for those patients in whom beta 2 blockade could be harmful.

Efficacy and safety of topical 2% dorzolamide and 0.5% timolol in cases of open angle glaucoma in a tertiary care hospital of East Singhbhum: an observational, prospective and comparative study

Background: Present study was undertaken to evaluate and compare the efficacy and side effects of 2% dorzolamide and 0.5% timolol in patients with open angle glaucoma.Methods: There were 60 randomly selected patients were equally divided into Group I (n=30) and Group II (n=30). Further both groups were divided into IA (n=10), IB (n=20), IIA (n=10) and IIB (n=20). 2% Dorzolamide hydrochloride in Group IA and IIA and 0.5% Timolol maleate in Group IB and IIB was administered for 24 weeks. Patients were evaluated for general and ocular examinations on day of enrolment and then at the end of 1st, 4th, 8th and 24th week. Adverse effects of the drug during study period were also noted. Mean±SD, t value, p value and comparison between groups were analysed by graph pad software.Results: At the end of 24 weeks difference in mean reduction of IOP was not significant with 6.2±1.85mm Hg (Right eye) and 5.55±1.68mm Hg (left eye) and 4.72±2.97mm Hg (Right eye) and 5.37±1.24mm Hg (left eye) in Group IA and Group IIA respectively. At the end of 24 weeks difference in mean reduction of IOP was not significant with 5.06±1.62mm Hg (Right eye) and 4.40±1.96mm Hg (left eye) and 4.30±1.41mm Hg (Right eye) and 4.12±2.08mm Hg (left eye) in Group IB and Group IIB respectively. Fall in both systolic and diastolic blood pressure in both the groups were significant. Both drug regimens were well-tolerated, and no serious drug-related adverse effects were reported.Conclusions: Dorzolamide was more efficacious for reduction of intra ocular pressure, well-tolerated, had low allergic response and had a favourable ocular, cardiovascular and respiratory safety profile than Timolol.

Effects of propranolol and timolol on proliferation and apoptosis of hemangioma stem cells / 中华整形外科杂志

Objective@#To investigate the effects of beta-blocker, propranolol and timolol on the proliferation and apoptosis of hemangioma stem cells (HemSCs).@*Methods@#Different concentrations(3, 30, 90, 150 μmol/L)of propranolol and timolol were added in HemSCs culture respectively for 24, 48 and 72 h, and cell proliferation and apoptosis were detected by flow cytometry. Experimental data were analyzed using SPSS 19.0 software. Statistically significance was determined using Student′s t test. Values of P<0.05 were considered statistically significant.@*Results@#Proliferation assay indicated that different concentrations of propranolol and timolol could inhibit HemSCs proliferation, and inhibition degree increased with increasing concentration. However, the effects of propranolol was slightly stronger than that of timolol at high concentrations (30, 90 and 150 μmol/L), but the opposite was observed at low concentration(3 μmol/L)(P<0.05). The results of apoptosis experiment showed that timolol had stronger effect than propranolol in promoting apoptosis at low concentrations (3 and 30 μmol/L), which was 13.7% and 1.1% higher, respectively.@*Conclusions@#Inhibiting HemSCs proliferation and promoting apoptosis may be one of the mechanisms of propranolol and timolol in treating infantile hemangioma.The specific effects of both varies with the concentration and time.

Clinical Observation of Different Combination Regimens of Latanoprost and Timolol in the Treatment of Primary Open-angle Glaucoma / 中国药房

OBJECTIVE:To observe the clinical efficacy and safety of different combination regimens of latanoprost combined with timolol in the treatment of primary open-angle glaucoma(POAG). METHODS:By 2×2 self-cross controlled regimen,a total of 50 POAG patients were selected from Sanya Municipal People's Hospital during Jan. 2014-Nov. 2016,and then divided into group A and B according to random number tablet,with 25 cases in each group. Group A received traditional regimens (Latanoprost eye drops,once every night,one drop each time+Timolol maleate eye drops,once in the morning and evening,one drop each time);after 8 weeks of treatment and 48 h washout period,group A was given modified regimen(Latanoprost eye drops,once every night,one drop each time+Timolol maleate eye drops,once every morning,one drop each time)for 8 weeks. Group B was given modified regimen;after 8 weeks of treatment and 48 h washout period,then was given traditional regimen for 8 weeks. The 24 h average intraocular pressure,peak and trough intraocular pressure before and after medication,ocular hemodynamics [end diastolic velocity(EDV),peak systolic velocity(PSV),resistance index(RI)] and ADR were recorded in 2 regimens. RESULTS:After received two regimens,24 h average intraocular pressure,peak and trough intraocular pressure, intraocular pressure fluctuation and RI were significantly lower than before treatment,while EDV and PSV were significantly higher than before treatment,with statistical significance(P<0.05). There was no statistical significance between 2 groups(P>0.05). The total incidence of ADR in patients receiving modified regimen was significantly lower than those receiving traditional regimen(4.0% vs. 22.0%),with statistical significance(P<0.05). CONCLUSIONS:In traditional combination regimen of latanoprost combined with timolol,the frequency of timolol use was changed from twice in the morning and evening to once in the morning,which doesn't influence therapeutic efficacy but reduce ADR.

The Effect of a Fixed Combination of 0.0015% Tafluprost-0.5% Timolol in Normal Tension Glaucoma Patients

PURPOSE: This study evaluated the effect of a fixed combination of 0.0015% tafluprost-0.5% timolol (Tapcom®, Santen, Osaka, Japan) in glaucoma patients. METHODS: This study included 23 patients who were diagnosed with normal tension glaucoma and treated with a fixed combination of 0.0015% tafluprost-0.5% timolol as the first therapy. Diurnal intraocular pressure (IOP) was measured every 2 and 0.5 hours between 9:00 am and 4:30 pm. The IOP change with respect to body position (positional IOP) was measured at baseline and at 6 months after eye-drop instillations. IOP fluctuation was defined as the standard deviation of IOP measurements. Throughout the study, all side effects were recorded and monitored by the investigators. RESULTS: The mean reduction in IOP in the 0.0015% tafluprost-0.5% timolol fixed combination-treated eyes was −3.37 ± 2.39 mmHg (−19.70 ± 13.97%) for the right eye and −3.22 ± 2.27 mmHg (-18.81 ± 13.28%) for the left eye (paired t-test, p < 0.001). The mean positional IOP measured at 4 pm at 6 months after 0.0015% tafluprost-0.5% timolol fixed combination instillation showed statistically significant reduction from the mean positional IOP at baseline. There was a significant difference in the number of patients with ≤3 mmHg IOP variation over four time points between baseline and at 6 months in the 0.0015% tafluprost-0.5% timolol fixed combination-treated eyes (McNemar test, p < 0.001). There was no serious adverse event causing ocular damage. CONCLUSIONS: Use of 0.0015% tafluprost-0.5% timolol fixed combination was effective and well tolerated in reducing IOP and in maintaining its effectiveness in glaucoma patients.

Comparison of Allergy Prevalence between Brimonidine/Timolol Fixed Combination and 0.15% Brimonidine in Glaucoma Patients

PURPOSE: To compare the allergy prevalence and clinical manifestations of 0.2% brimonidine/0.5% timolol fixed combination (BTFC) and 0.15% brimonidine in Korean patients with glaucoma. METHODS: We retrospectively analyzed the medical records of 196 glaucoma patients treated with BTFC and 234 glaucoma patients treated with 0.15% brimonidine. We compared sex, age, type of glaucoma, treatment period, allergy history, onset time of ocular allergy and clinical characteristics of allergy in the two groups. RESULTS: Ocular allergy percentages 10.14% in the BTFC group and 22.02% in the 0.15% brimonidine group, and the risk of allergy was approximately 0.4 times lower in patients using BTFC (hazard ratio = 2.5, p = 0.009). The BTFC group developed ocular allergy at a mean of 20.5 months (range: 1.7–51.1 months), and the 0.15% brimonidine group developed ocular allergy at a mean of 7.7 months (range: 0.4–50.8 months). In the BTFC group, 50% of the ocular allergy occurred within 15 months, and within 5 months in the 0.15% brimonidine group. Clinical characteristics of brimonidine allergy involved two types of conjunctival follicles and conjunctival papillae, but there were no significant differences in incidence according to allergy type (p = 0.566). CONCLUSIONS: The prevalence of ocular allergy in the BTFC group was lower than that in the 0.15% brimonidine group in Korean patients with glaucoma. The results of this study are expected to be useful for patient education and compliance improvement using brimonidine.