Timolol treatment of chronic open-angle glaucoma and ocular hypertension. A 2.5-year multicenter study.

Maintenance effect of topical timolol was investigated for 2 years in a group of 125 glaucomatous and ocular hypertensive patients (231 eyes) who had been successfully treated with timolol alone during a 6-month period preceding this trial. Intraocular pressure (IOP) was controlled with timolol alone in 135 of 183 eyes (74%) that completed the study. At the end of the trial 142 eyes (78%) showed an IOP of less than 22 mmHg. Other glaucoma medication had to be added to timolol treatment in 18% of ocular hypertensive and 35% of glaucomatous eyes because of IOP elevation. Elevation of IOP seemed to be due to worsening of glaucoma rather than to decreased efficacy of timolol. None of the ocular hypertensive patients developed visual field defects but in ten glaucomatous patients progression of existing visual field defects was observed in association with elevated IOP. Transient adverse effects were observed in 13% of cases, but timolol treatment had to be stopped in only five cases (4%) because of side effects.

The IOP-lowering effect of timolol in simple and capsular glaucoma. A multicenter study in Finland.

Timolol maleate eye drops (0.25% and 0.5%) were used alone or in combined treatment in 220 patients with simple or capsular glaucoma. A highly significant (P less than 0.001, mean -9.4 mm Hg,-29%) decrease in the intraocular pressure (IOP) was seen in 196 (164 simple, 32 capsular) patients in the beginning of the study using timolol alone. (Inadequate control timing, deviation from the treatment definition, or adverse reactions caused the exclusion of the data of 24 patients). A total of 180 patients (151 simple, 29 capsular) completed the 6-month study. At the end of the study an IOP less than 22 mm Hg was seen in 103 (57.2%, 91 simple, 12 capsular) patients treated with timolol alone. During the follow-up period there was no significant difference in the IOP-lowering effect of timolol in the simple and the capsular group using timolol alone. Combined treatment was needed by 39 of 180 patients who completed the study. It was needed more than twice as often in the capsular group (12 patients, 41.4%) as in the simple group (27 patients, 17.9%). The IOP increased above 25 mm Hg in one-fourth of these 39 patients during the follow-up period, but there was no significant difference between the simple and the capsular group. Six patients dropped out of the study because of side-effects possibly related to timolol therapy.

The natural history of gyrate atrophy of the choroid and retina.

Twenty-nine Finnish patients (8-80 years old during follow-up) with hyperornithinemia and gyrate atrophy (HOGA) were followed 2 to 31 years to determine when and how rapidly visual acuities and visual functions were affected by the disease. Considerable variability was observed both in the age at which visual acuities began to decrease and the age at which visual acuities reached 20/200. Acuities in phakic eyes tended to decrease from 20/30 to 20/200 in ten years or less, while aphakic eyes exhibited generally slower loss of vision. Without benefit of cataract surgery, the percentage of eyes with acuity 20/200 or worse would have been 37% at age 30 and 64% at age 40, but through surgery actually performed was 20% at age 40. Constriction of visual fields with age was marked and correlated well with diminution in dark adaptation.