Glaucoma Medication Preferences among Glaucoma Specialists in Mexico.

AIM: To determine the glaucoma specialists' preferences for the different brands of topical glaucoma medications available in Mexico. MATERIALS AND METHODS: A web-based survey was sent to 150 board-certified glaucoma specialists in Mexico, with 14 questions related to brand preferences for all glaucoma medications available in Mexico. Participants were asked to select each glaucoma medication class by brand and to state the factors leading to their choice. RESULTS: Data from 111 (74%) glaucoma specialists were collected. Imot (timolol 0.5%; Sophia, Mexico) was the preferred brand for the beta-blockers (BB) class by 71% (n = 79) of the participants. Azopt (brinzolamide 1%; Alcon Lab, US) was the preferred carbonic anhydrase inhibitor (CAI) by 54% (n = 60) of the glaucoma specialists. Lumigan (bimatoprost 0.01% and 0.03%; Allergan Inc., U.S.) was the first choice for the prostaglandin analogues (PGAs) in 62% (n = 70) of the answers. The most frequently prescribed alpha-agonist (AA) was Agglad (brimonidine 0.2%; Sophia Lab, Mexico) in 44% (n = 49) of the answers. Medication accessibility (31%), cost (29%), and recommended dose (23%) were the three main factors influencing the glaucoma specialists' preferences. CONCLUSION: Medication cost and accessibility, as well as posology, remain the main factors influencing brand preferences among glaucoma doctors. In our professional opinion, the therapeutic effect must be the leading factor when prescribing topical medications in the daily practice, so that patients receive the best treatment option. CLINICAL SIGNIFICANCE: This survey provides an understanding of the decision-making process when prescribing glaucoma medications by glaucoma specialists in a Latin American developing country. Ideally, patient treatment should be individualized and aimed to achieve the best results possible for their specific condition.How to cite this article: Lazcano-Gomez G, Alvarez-Ascencio D, Haro-Zuno C, Turati-Acosta M, Garcia-Huerta M, Jimenez-Arroyo J, Castañeda-Diez R, Castillejos-Chevez A, Gonzalez-Salinas R, Dominguez-Dueñas F, Jimenez-Roman J. Glaucoma Medication Preferences among Glaucoma Specialists in Mexico. J Curr Glaucoma Pract 2017;11(3):97-100.

Early Glaucoma Screening Using the Ibopamine Provocative Test.

PURPOSE: To evaluate the diagnostic ability of the ibopamine provocative test for early glaucoma detection. METHOD: A sample of 44 patients with suspicious optic discs was recruited and compared with 37 controls with normal optic discs and no ocular pathology. The ibopamine test was performed in all patients who were then followed up with diagnostic tests for glaucoma, visual fields, and spectral-domain optical coherence tomography. RESULTS: Early glaucoma was diagnosed in 26 patients. The sensitivity of the ibopamine test to discriminate patients who had early glaucoma was 78.7%, with a specificity of 71.6%. In multivariable analyses adjusted for demographic and clinical variables, participants with a positive ibopamine test at baseline had an 8-fold higher risk of glaucoma compared with those who had a negative test; glaucoma risk was highest among ibopamine-positive subjects with initial clinical diagnostic impression of glaucoma. CONCLUSIONS: The ibopamine test showed an adequate diagnostic performance to detect individuals at increased risk of glaucoma in a very early stage of the disease. While further studies are required, the provocative ibopamine test for the diagnosis of early glaucoma is promissory.

Oral ivermectin for treatment of pediculosis capitis.

BACKGROUND: Pediculosis capitis is a highly transmissible infestation prevalent worldwide. It is an important public health problem mainly affecting children. The emergence of drug resistance and high rates of treatment failure with several topical agents makes ivermectin, an antiparasitic drug, an attractive therapeutic option for lice control. OBJECTIVE: To evaluate the efficacy and safety of oral ivermectin in the treatment of a pediatric population with pediculosis capitis. METHODS: Children with pediculosis capitis from the ages of 6 to 15 years were recruited from an indigenous community in Mexico, and were treated with a single dose of oral ivermectin at 200 µg/kg. They were treated with a second dose of ivermectin 1 week later if there was evidence of persistent infestation. RESULTS: Forty-four children (mean age, 9.8 years) with active infestation were treated. A single approximately 200-µg/kg dose of ivermectin eradicated adult lice in all children. Forty-one percent (n = 18) required a second dose because of the presence of viable nits. At the third visit, 2 weeks after commencement of treatment there was no evidence of viable nits, and there was complete resolution of excoriations in all children and minimal or no symptoms of pruritus were reported in 93% (n = 41). There were no significant adverse effects due to ivermectin administration. CONCLUSIONS: Ivermectin demonstrates high efficacy and tolerability in the treatment of pediculosis capitis in children. A significant number of children required a second dose to ensure complete eradication.