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Julian García-Feijoo,1 Francisco J Muñoz-Negrete,2 Douglas A Hubatsch,3 Gemma C Rossi4 On behalf of the study investigators 1Department of Ophthalmology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense, OFTARED, 2Hospital UniversItario Ramón y Cajal, Universidad de Alcalá, IRYCIS, OFTARED, Madrid, Spain; 3Alcon Laboratories, Inc., Fort Worth, TX, USA; 4Department of Ophthalmology, University Eye Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy Introduction: The preservative benzalkonium chloride (BAK) is used to preserve several topical, intraocular pressure (IOP)-lowering glaucoma medications but can cause tolerability concerns that may lead to decreased adherence to treatment and ultimately diminish the effectiveness of IOP control. The study aimed to determine the efficacy and tolerability of BAK-free travoprost preserved with polyquaternium-1 in glaucoma patients switched from BAK-preserved latanoprost or bimatoprost.Methods: This 12-week, open-label study was conducted in Europe between December 2011 and February 2013. We enrolled adult patients with open-angle glaucoma or ocular hypertension who were receiving BAK-preserved latanoprost 0.005% or bimatoprost 0.01% and, in the opinion of the investigator, would benefit from transition to BAK-free travoprost 0.004% preserved with polyquaternium-1 because of tolerability concerns. Assessments included IOP, proportion of patients with IOP ≤18 mmHg, ocular surface status, hyperemia, patient treatment preference, and adherence. Adverse events were recorded throughout the study.Results: Of the 202 patients screened, 187 patients were included in the intent-to-treat population (mean age, 66.6 years; range, 19–90 years). The mean IOP significantly reduced from baseline (17.0 mmHg) to week 6 (mean change, -1.17 mmHg; P

Shamira A Perera,1–3 Daniel SW Ting,1,2 Monisha E Nongpiur,1–3 Paul T Chew,3 Maria Cecilia D Aquino,3 Chelvin CA Sng,3 Sue-Wei Ho,1,2 Tin Aung1–3 1Singapore Eye Research Institute, Singapore; 2Singapore National Eye Centre, Singapore; 3Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Purpose: To investigate the efficacy and safety of a punctum plug-based sustained drug release system for a prostaglandin analog, travoprost (OTX-TP), for intraocular pressure (IOP) ­reduction in an Asian population. Methods: This is an initial feasibility, prospective, single-arm study involving 26 eyes and a bioresorbable punctum plug containing OTX-TP. An OTX-TP was placed in the vertical portion of the superior or inferior canaliculus of patients with primary open-angle glaucoma or ocular hypertension. The main outcome measure was the IOP-lowering efficacy of OTX-TP at 3 (8 am) and 10, 20, and 30 days (8 am, 10 am, and 4 pm), compared to baseline. Results: A total of 26 OTX-TP were inserted for 17 subjects. The mean (standard deviation) age was 57.2 (13.8) years. At 10 days, all plugs were still present, and the IOP reduction from baseline was 6.2 (23%), 5.4 (21%), and 7.5 mmHg (28%) at 8 am, 10 am, and 4 pm, respectively. At 10 days, the mean IOP (standard error of mean) was 21.2 (1.2), 20.4 (0.8), and 19.7 (1.0) at 8 am, 10 am, and 4 pm, respectively, showing no discernible IOP trend during the course of the day. At 30 days, plug retention had declined to 42%, and the overall IOP reduction had decreased to 16%. Conclusion: The sustained-release OTX-TP is able to reduce IOP by 24% (day 10) and 15.6% (day 30), respectively. It is a potentially well-tolerable ocular hypotensive for glaucoma patients with a history of poor compliance. Keywords: ocular hypertension, travoprost, bioresorbable, punctum plug, glaucoma, Asian

pharmacoeconomic study of treatment primary open-angle glaucoma with combinations of prostaglandin analogues and beta-blockers by mean of cost-efficacy and budget impact analysis. Results have shown, that Duotrav (travoprost+timolol) has benefits compare with Xalacom (latanoprost+timolol) from cost-efficacy perspective and can be claimed dominant. Futhermore Doutrav in comparison with Xalacom provides cost-saving and advantage in terms of budget impact analysis

Purpose: Periorbital fat atrophy is a known side effect of topical prostaglandin analogs (PA). This side effect may have implications in the treatment of diseases like thyroid orbitopathy. In this in vivo study we aimed to evaluate the effects of retrobulbar injection of three different PAs on orbital fat., Methods: Eighteen adult male Wistar-albino rats were divided into three groups of six animals. 0.1 ml of 0.03% bimatoprost, 0.005% latanoprost, or 0.005% travoprost was injected into the right orbits and saline was injected into the left orbits, as controls. Both orbits were exenterated after 3 weeks. Histological cross-sections were analyzed using ImageJ image analysis software. Intraconal adipocyte density was calculated., Results: There was no significant difference in the adipocyte density between the PA injected orbits and the control side in each of the three groups. When calculations from all three groups were analyzed together, again the difference in the adipocyte density between the PA injected orbits and the control side was not significant., Conclusion: No significant fat atrophy was noted in this rat model three weeks after retrobulbar injection of PAs. To evaluate retrobulbar injection of PA as a potential therapy for orbital diseases with fat proliferation, in vivo studies in different animal models, higher concentrations of PA, or longer follow-up duration are required., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Purpose: To assess the effects of prostaglandin F2α analogues travoprost on the biomechanical behavior of ex-vivo rabbit cornea. Materials and Methods: 18 Japanese white rabbits were included in the study. The left eye (treated group, Tr) of each rabbit was preserved for 10 days in storage medium Eusol-C solution with 1:10 travoprost diluent, while the contralateral eye (control group, Co) was preserved in a similar but travoprost-free medium. Strips of corneal tissue were dissected and tested under cyclic load conditions with up to 0.1 N uniaxial tension force. The resulting load-elongation data were used to derive the stress-strain behavior and the tangent modulus (Et) of the tissue. Differences in Et between the treated (Et-Tr) and control group (Et-Co) were assessed statistically to determine the biomechanical effects of travoprost on the cornea. Results: Central corneal thickness (CCT) in the two groups was similar before (P = 0.073) and remained similar after storage (P = 0.303) although it became significantly thicker in both groups after preservation (P < 0.01). Compared with the control group, the travoprost treated corneas exhibited lower Et values but the differences reduced and became insignificant with rises in stress to which the tissue was subjected (1 - Et-Tr/Et-Co = −11.7 ± 41.8%, P < 0.05 at 10 kPa stress; −9.2 ± 36.1%, P > 0.05 at 20 kPa; −7.3 ± 35.4%, P > 0.05 at 30 kPa). Conclusions: Significant reductions in corneal stiffness, that are associated with the use of travoprost, were observed experimentally under low applied stresses. This stiffness-reduction effect should be considered in clinical management, especially in primary open angle glaucoma treatment. [ABSTRACT FROM AUTHOR]

Purpose: To report the rare incidence of retinal pigment epithelial detachment (RPED) followed by topical travoprost therapy and its subsequent reattachment after cessation of the drug.Methods: A 60-year-old male presented with gradual loss of vision in both eyes and distorted images in right eye. He gave a history of visiting an ophthalmologist a week ago for a routine eye examination. His previous reports revealed best-corrected visual acuity (BCVA) of 6/6, N6 in both eyes with raised intraocular pressures. A diagnosis of primary open-angle glaucoma was made and prescribed topical travoprost 0.004% eye drops. This patient’s subsequent visit with diagnosis and treatment is mentioned in this case report.Results: On examination, his BCVA was found to be 6/36, N12 and 6/6, N6 in right and left eyes, respectively. Optical coherence tomography (OCT) macular scan revealed RPED involving fovea in the right eye and inferotemporal to fovea in the left eye. Patient was advised to discontinue topical travoprost and started brinzolamide 1% eye drops. Ten-day follow-up visit revealed partially resolved RPED by OCT with 6/9 and 6/6 visual acuity in the right and left eyes, respectively. After 1 month, reversal of RPED was noted in OCT with 6/6 vision in both eyes.Conclusion: Hence, clinicians should be aware of this rare incidence of RPED followed by travoprost therapy. First case of RPED following travoprost therapy and complete reattachment upon withdrawal is reported here in this case report. [ABSTRACT FROM AUTHOR]

Topic. Prostaglandin analogues (PGAs) are first-line medical therapy for primary open angle glaucoma (POAG) and ocular hypertension (OHT). Intraocular pressure (IOP) lowering effects in full responders are known to be 25–33% for this class; however, partial responders and nonresponders do exist. In clinical trials or prospective series, discontinuation and washout of PGAs is necessary to evaluate true change in IOP from novel surgeries and medical therapies. Clinical Relevance. To identify all relevant papers with pertinent data on washout of PGAs and quantify the duration and long-term effect of reported PGA washout periods in glaucoma and OHT patients. Methods. A systematic review and meta-analysis was conducted to investigate the long-term effects on IOP after discontinuation of topical PGAs POAG and OHT patients. The main search was conducted in MEDLINE/PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, and BIOSIS Previews and conference proceedings. Results. 1055 papers were identified, 548 were independently screened by two physicians., and 56 papers were analyzed for washout durations. The mean washout was found to be 4.56 weeks (±1.25), with the mode and median being 5 weeks. Five studies were analyzed as randomized control trials in which latanoprost was discontinued for 4 weeks prior to restarting another intraocular pressure-lowering drug. Meta-analysis revealed a 4-week discontinuation of latanoprost, on average, subjects returned to their baseline IOP. Conclusion. A significant IOP-lowering effect of latanoprost was not observed beyond 4 weeks, suggesting this may be an appropriate washout period for latanoprost. We could not identify appropriate washout periods for either travoprost or bimatoprost, although a majority of articles had 4-week washout durations for the two drugs. Despite the widespread use of this class of medication, there is a paucity of literature on the effects of PGA washout in patients that are treatment naïve to other topical medications. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of travoprost eye drops oil intraocular pressure, hemodynamics and endothelin-1 (ET-1) and matrix metalloproteinase-2 (TTMP-2) in patients with primary open-angle glaucoma (POAG). Methods: A total of 70 patients, who were treated in the 59th Hospital of PLA from February 2015 to February 2017, were randomly divided into control group (n=35) and observation group (n=35). The control group and die observation group were treated with timolol maleate eye drops and travoprost eye drops respectively for 3 months. The average intraocular pressure (IOP) and day and night IOP difference were comparatively analyzed before treatment. 4 weeks, 3 weeks and 12 weeks after treatment. The posterior ciliary artery (PCA), central retinal artery (CRA), peak systolic velocity (PSV), end diastolic velocity (EDV) and vascular resistance index (RJ), plasma ET-1 and improve situation of aqueous humor TIMP-2 were compared before treatment and 12 weeks after treatment. Results: There were no significant differences in average IOP, day and night IOP difference, hemodynamics of PCA and CRA. plasma ET-1 and aqueous humor TIMP-2 between the two groups before treatment (P<0.05). After 4 weeks, 8 weeks and 12 weeks of treatment, average IOP and day and night IOP difference of the two groups were significantly lower than those before treatment, and average IOP and day and night IOP difference in the observation group were lower than those in the control group after 12 weeks treatment, the differences were statistically significant (P<0.05). After 12 weeks of treatment, the PSV and EDV of PCA and CRA in the observation group were higher than those before treatment, RI was lower than that before treatment, the differences were statistically significant (F0.05). The PSV and EDV of PCA and CRA in the observation group were higher than those in the control group, RI was lower than mat in the control group, the differences were statistically significant (P;0.05). After 12 weeks of treatment, the plasma ET-1 and aqueous humor TIMP-2 in the two groups were significantly lower than those before treatment, and the contents of plasma ET-1 and aqueous humor TIMP-2 in the observation group were lower than those in the control group, the differences were statistically significant (P<0.05). Conclusion: Travoprost eye drops can effectively reduce the levels of IOP. plasma ET-1 and aqueous humor TTMP-2 in the treatment of patients with POAG, and improve the hemodynamics of CRA and PCA. [ABSTRACT FROM AUTHOR]

Aim. The purpose of this study is to evaluate and compare the efficacy of 4 prostaglandin analogues (PGAs) and to determine the incidence of ocular surface disease in newly diagnosed, primary open-angle glaucoma (POAG) patients started on one of those 4 PGAs: bimatoprost (benzalkonium chloride, BAK, 0.3 mg/mL), latanoprost (BAK 0.2 mg/mL), travoprost (polyquad), and tafluprost (BAK-free). Patients and Methods. In this single-center, open-label trial, 32 patients newly diagnosed with POAG were randomly started on one of the four PGAs. All patients underwent a complete ophthalmological exam at presentation and at 1, 3, and 6 months of follow-up. Dry eye disease (DED) was assessed using the original Ocular Surface Disease Index (OSDI) questionnaire, in order to evaluate the impact of the drops on the quality of life of patients. Results. The mean age was 60.06 years ± 11.76. All four drugs equally and significantly reduced the intraocular pressure (IOP) with respect to the baseline IOP. There was a trend for a slightly greater reduction of IOP with bimatoprost, but the difference was not found to be statistically significant when compared to other PGAs. OSDI scores were significantly superior for travoprost (10.68 ± 5.73) compared to the other three drugs (p<0.05). Latanoprost caused the most significant eyelash growth and iris discoloration. Conjunctival hyperemia and superficial keratitis occurrence were similar in the four groups. Conclusion. All prostaglandin analogues equally and significantly reduce the IOP in patients with POAG. According to the results of the OSDI score, latanoprost seems to be the least tolerated among the four drugs. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this prospective study was to compare the efficacy of latanoprost, bimatoprost, and travoprost in lowering intraocular pressure (IOP) and in preventing or delaying visual field loss in patients with primary open-angle glaucoma (POAG) and ocular hypertension (OH). Materials and Methods: The study included 124 eyes of 73 patients who were diagnosed in our clinic as having POAG or OH. All of the patients had IOP values of 22-34 mmHg, an early diagnosis of POAG or OH, without any previous treatment. The patients were randomly divided into 3 Groups: Group 1; 42 eyes treated with latanoprost (0.005%), Group 2; 40 eyes treated with bimatoprost (0.03%), and Group 3; 42 eyes treated with travoprost (0.004%). The visual field has been evaluated via the Humprey visual field evaluation of statistical program Statpac mean deviation (MD) and pattern standard deviation (PSD). The IOP, MD, and PSD values have been measured initially and at the end of the first year of treatment. Results: In comparison to the baseline, the mean changes of IOP values after one year of treatment were 6.99, 6.79 and 5.87 mmHg for the 3 Groups, respectively. The decrease in the IOP was statistically significant for each of the treatment groups (p0.05). Comparison of the MD and PSD values revealed no significant differences among the treatment groups both initially and at the end of the first year (p>0.05). The mean changes in MD and PSD values at the end of the first year were similar among the treatment groups (p>0.05). Conclusion: In patients with POAG and OH, treatment with latanoprost, bimatoprost, and travoprost decrease the IOP effectively. After a one-year treatment, no significant difference has been found between the efficacy of the 3 drugs in lowering IOP and in preventing or delaying visual field loss. (Turk J Ophthalmol 2014; 44: 170-4)

AIM: To compare the short-term efficacy of domestic and imported prostaglandins(PGs)for patients first diagnosed as primary open angle glaucoma. METHODS: This study was a prospective positive drug control trial and 338 patients diagnosed as primary open angle glaucoma at the first time. According to patients' wills, they were divided into the experiment group(181 cases)and the control group(157 cases). Domestic latanoprost eye drops with 0.05g/L was used for 3mo in the experimental group while imported travoprost eye drops with 0.04g/L was used in the control group for 3mo. All patients were typically treated at 21:00 every day within a 3mo period. Intraocular pressure(IOP)was measured before treatments and post treatments at 1, 2 and 3mo respectively, in each group. RESULTS: For the experimental group, IOP was 28.32±5.72, 21.84±4.63, 19.53±4.04 and 18.15±3.35mmHg before treatments and post treatments at 1,2 and 3mo respectively, showing a significant difference among various time points(F=370.019,P=0.000),and the IOPs were markedly lower post treatments than those before treatments(all PF=306.052,P=0.000),and the IOP were markedly lower post treatments than those before treatments(all PP=0.144,0.456, 0.051). CONCLUSION: Domestic latanoprost eye drops can reduce IOP effectively, with a suitable price, and it can be used as a first choice for primary open angle glaucoma patients in the basic-level hospitals.