Structure-function relationship in a series of glaucoma cases.

PURPOSE: To map retinal sensitivity and peripapillary retinal nerve fiber layer (RNFL) thickness, as measured by standard automated perimetry (SAP) and optical coherence tomography (OCT) respectively, in patients with various stages of primary open-angle glaucoma (POAG). METHODS: Ninety patients with POAG were prospectively selected for SAP and for OCT RNFL thickness measurements. Factorial analysis performed independently for each hemifield was used to identify groups of related SAP visual field points. Pearson correlation coefficients were determined between visual field regions and peripapillary RNFL sectors and these data used to construct structure-function correlation maps for the various disease stages. RESULTS: Factorial analysis identified 4 factors or visual field regions for the inferior hemifield and 5 for the superior hemifield. For all patients and the subset of patients with advanced POAG, the strongest correlation was detected between the superior hemifield and the inferior RNFL sectors, while higher correlations for incipient and moderate disease stages were observed between the inferior hemifield and the superior RNFL sectors. CONCLUSIONS: In these patients, functional and structural damage can be mapped such that each zone of related SAP points correlates with one or several peripapillary RNFL zones. Such maps could improve our understanding of structure-function relationships in glaucoma.

Correlations between peripapillary retinal nerve fiber layer thickness and macular thickness in different various stages of primary open-angle glaucoma.

PURPOSE: To determine the relationship between macular thickness and peripapillary retinal nerve fiber layer (RNFLp) thickness in different stages of primary open-angle glaucoma (POAG). METHODS: Ninety prospectively selected patients with different stage POAG underwent spectral domain optical coherence tomography (SD-OCT) to determine macular and RNFLp thicknesses in different regions and sectors respectively. Correlations were then established through Pearson's correlation coefficient between RNFLp and macular thicknesses in the different disease stages. RESULTS: Greatest correlation was observed between the inferior RNFLp sector and the internal inferior macula both in the whole patient population and in the subset of patients with incipient glaucoma. CONCLUSIONS: When the optic nerve disc is affected by another condition, macular thickness determination may help detect POAG and monitor its progression.

[The influence of the Travalert(®) dosing aid on medical treatment compliance and the quality of life of glaucoma patients]. / Estudio de la influencia del dispositivo de ayuda a la dosificación Travalert(®) sobre el cumplimiento del tratamiento médico y calidad de vida de los pacientes con glaucoma.

PURPOSE: To study compliance in the medical treatment of glaucoma, its possible association with other factors, and quality of life of patients with glaucoma. MATERIAL AND METHODS: Longitudinal prospective study of 60 patients with ocular hypertension or glaucoma who were treated with travoprost, or with a fixed combination of travoprost/timolol nightly. All subjects were given a Travalert(®) dosing aid and were reviewed after one and four months. Strict and relative compliance data were collected on each visit. The relationship between compliance and other variables was studied using univariate analysis. To analyse quality of life, patients were given self-assessment STAI anxiety questionnaires after the first and last visits. RESULTS: Relative compliance for the four months was significantly greater than the strict compliance (P=.001). In the group of least compliance the number of patients on treatment with combination therapy was significantly higher than those on monotherapy. In the lost cases, the number of men was significantly higher than women. No association was found in the other variables. The anxiety was similar to that in the normal population. CONCLUSIONS: Compliance is very important in the treatment of glaucoma, and our study provides objective data through the use of Travalert dosing aid with relative compliances of 70%. Patients with combined therapies have lower compliance than those on monotherapy.

Estudio de la influencia del dispositivo de ayuda a la dosificación Travalert (R) sobre el cumplimiento del tratamiento médico y calidad de vida de los pacientes con glaucoma / The influence of the Travalert (R) dosing aid on medical treatment compliance and the quality of life of glaucoma patients

Objetivos: Estudiar el cumplimiento en el tratamiento médico del glaucoma y su posible asociación con otros factores, así como la calidad de vida de los pacientes con glaucoma.Material y métodosEstudio prospectivo longitudinal en 60 pacientes con hipertensión ocular o glaucoma que recibían tratamiento con travoprost o con la combinación fija travoprost/timolol todas las noches. Se les entregó a todos los sujetos el dispositivo Travalert de ayuda a la dosificación y se les revisó al mes y al cuarto mes recogiendo el cumplimiento estricto y relativo en cada visita. Mediante un análisis univariante se estudió la relación entre el cumplimiento y otras variables.Para analizar la calidad de vida, se entregó a los pacientes el cuestionario de autoevaluación de ansiedad STAI en la visita de entrada y en la de salida.ResultadosEl cumplimiento relativo a los cuatro meses fue significativamente mayor que el estricto (p=0,001). En el grupo de menor cumplimiento el número de pacientes que recibía terapia combinada resultó significativamente mayor que en el de aquellos que recibían monoterapia. Al estudiar los casos perdidos, el número de hombres fue significativamente mayor que el de mujeres. No se encontró asociación estadística en el resto de variables. La ansiedad fue similar a la población normal.ConclusionesEl cumplimiento es de vital importancia en el tratamiento del glaucoma, nuestro estudio aporta datos objetivos mediante el sistema electrónico Travalert porque muestra un cumplimiento relativo del 70%. Los pacientes con terapias combinadas presentan menor cumplimiento que aquellos en monoterapia (AU)

Purpose: To study compliance in the medical treatment of glaucoma, its possible association with other factors, and quality of life of patients with glaucoma.Material and methodsLongitudinal prospective study of 60 patients with ocular hypertension or glaucoma who were treated with travoprost, or with a fixed combination of travoprost/timolol nightly. All subjects were given a Travalert® dosing aid and were reviewed after one and four months. Strict and relative compliance data were collected on each visit. The relationship between compliance and other variables was studied using univariate analysis. To analyse quality of life, patients were given self-assessment STAI anxiety questionnaires after the first and last visits.ResultsRelative compliance for the four months was significantly greater than the strict compliance (P=.001). In the group of least compliance the number of patients on treatment with combination therapy was significantly higher than those on monotherapy. In the lost cases, the number of men was significantly higher than women. No association was found in the other variables. The anxiety was similar to that in the normal population.ConclusionsCompliance is very important in the treatment of glaucoma, and our study provides objective data through the use of Travalert dosing aid with relative compliances of 70%. Patients with combined therapies have lower compliance than those on monotherapy (AU)

[Comparative study of the pressure lowering efficacy and variations in the ocular pulse amplitude between fixed combinations of dorzolamide/timolol and brinzolamide/timolol]. / Estudio comparativo de la eficacia hipotensora y de las variaciones en la amplitud de pulso ocular entre las combinaciones fijas dorzolamida/timolol y brinzolamida/timolol.

OBJECTIVE: To determine possible differences in the intraocular pressure (IOP) and ocular pulse amplitude (OPA) lowering capacity of the fixed drug combinations dorzolamide/timolol and brinzolamide/timolol. METHODS: In this cross-sectional study, one of the eyes of 25 healthy subjects was randomly assigned to treatment with dorzolamide/timolol and the other eye with brinzolamide/timolol. After instilling the drops, possible adverse effects (e.g., blurred vision, itching) were assessed in each eye. This assessment was repeated 30 minutes later. IOP and OPA were determined In each eye by dynamic contour tonometry at baseline and two hours following treatment. RESULTS: Both fixed drug combinations significantly reduced IOP and OPA with no differences detected between treatment groups. Among the adverse effects recorded, itching was significantly greater in the first assessment in the eyes treated with dorzolamide/timolol (P = .011). This difference was no longer apparent in the second assessment. CONCLUSIONS: Both fixed combinations were similarly effective in reducing intraocular pressure and ocular pulse amplitude. Adverse effects related to both treatments were mild and well-tolerated, though itching occurred most frequently in the eyes treated with dorzolamide/timolol.

Estudio comparativo de la eficacia hipotensora y de las variaciones en la amplitud de pulso ocular entre las combinaciones fijas dorzolamida/timolol y brinzolamida/timolol / Comparative study of the pressure lowering efficacy and variations in the ocular pulse amplitude between fixed combinations of dorzolamide/ timolol and brinzolamide/timolol

Objetivo: Evaluar las diferencias en cuanto a eficacia hipotensora y amplitud de pulso ocularentre las combinaciones fijas de dorzolamida/timolol y brinzolamida/timolol.Métodos: Estudio transversal en 25 sujetos sanos. En cada paciente uno de los ojos fue tratadocon la combinación fija dorzolamida/timolol y el otro con brinzolamida/timolol. La asignaciónfue realizada al azar en cada paciente. Tras la instilación, mediante una escala visualanalógica se evaluaron los posibles efectos adversos (visión borrosa, picor. . .) en cada uno delos ojos. Esta evaluación se repitió a los 30 minutos de la instilación. Mediante un tonómetrode contorno dinámico se registró la presión intraocular y la amplitud de pulso ocular a nivelbasal y a las dos horas de la instilación.Resultados: Ambas combinaciones fijas disminuyeron de forma significativa la presión intraoculary la amplitud de pulso ocular sin diferencias significativas entre los dos grupos detratamiento. De los acontecimientos adversos evaluados, el picor fue significativamentemayor en los ojos tratados con dorzolamida/timolol en la primera medida (p = 0,011). Estadiferencia desapareció en la segunda evaluación.Conclusiones: Ambas combinaciones fijas demostraron ser igualmente eficaces, produciendovariaciones similares y significativas en la amplitud de pulso ocular. Los efectos adversosfueron en ambos casos leves y bien tolerados presentándose únicamente el picor como másfrecuente en los ojos tratados con dorzolamida/timolol(AU)

Objective: To determine possible differences in the intraocular pressure (IOP) and ocular pulseamplitude (OPA) lowering capacity of the fixed drug combinations dorzolamide/timolol andbrinzolamide/timolol.Methods: In this cross-sectional study, one of the eyes of 25 healthy subjects wasrandomly assigned to treatment with dorzolamide/timolol and the other eye with brinzolamide/timolol. After instilling the drops, possible adverse effects (e.g., blurred vision,itching) were assessed in each eye. This assessment was repeated 30 minutes later. IOP andOPA were determined In each eye by dynamic contour tonometry at baseline and two hoursfollowing treatment.Results: Both fixed drug combinations significantly reduced IOP and OPA with no differencesdetected between treatment groups. Among the adverse effects recorded, itching wassignificantly greater in the first assessment in the eyes treated with dorzolamide/timolol(P = .011). This difference was no longer apparent in the second assessment.Conclusions: Both fixed combinations were similarly effective in reducing intraocular pressureand ocular pulse amplitude. Adverse effects related to both treatments were mild andwell-tolerated, though itching occurred most frequently in the eyes treated with dorzolamide/timolol(AU)