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Intraocular Pressure Following Prerandomization Glaucoma Medication Washout in the HORIZON and COMPASS Trials
- Source :
- American journal of ophthalmology. 216
- Publication Year :
- 2020
-
Abstract
- To assess the effectiveness of topical ocular hypotensive medications in patients with open-angle glaucoma and to identify factors associated with postwashout intraocular pressure (IOP) elevation.Secondary analysis of prerandomization data from 2 prospective, multicenter, randomized clinical trials.Fourteen hundred subjects (1,400 eyes, 781 from the HORIZON study of the Hydrus micro-stent and 619 from the COMPASS study of the Cypass micro-stent) with primary open-angle glaucoma who were using 0-4 classes of topical IOP-lowering medication underwent Goldmann applanation tonometry before and after a protocol-defined washout period.The mean (standard deviation) age was 70.7 (8.0) years and 55.6% were female. The change in IOP following washout for patients using 0 (n = 100), 1 (n = 705), 2 (n = 355), 3 (n = 214), or 4 (n = 26) medications was 0.2 (2.8), 5.7 (3.3), 6.9 (3.7), 8.8 (5.0), and 9.5 (4.1) mm Hg, respectively (P.001, Kruskal-Wallis test). Postwashout IOP change was similar between the HORIZON and COMPASS cohorts. No difference in postwashout IOP change was detected among individual prostaglandin analogues in patients on monotherapy. A generalized linear model identified the following factors to be associated with greater IOP rise upon medication washout: greater number of glaucoma medications, higher unmedicated IOP, thinner central corneal thickness (CCT), lack of prior selective laser trabeculoplasty (SLT), and male sex.Cessation of glaucoma medications results in a dose-dependent IOP increase in treated open-angle glaucoma patients. Two independent clinical trial cohorts exhibit similar levels of IOP elevation upon washout, using standardized methodology to estimate real-world medication effectiveness. Thicker CCT and history of SLT may predict reduced response to IOP lowering medications.
- Subjects :
- Male
Intraocular pressure
medicine.medical_specialty
Trabeculoplasty
genetic structures
medicine.medical_treatment
Glaucoma
Administration, Ophthalmic
law.invention
Prosthesis Implantation
03 medical and health sciences
Tonometry, Ocular
0302 clinical medicine
Randomized controlled trial
law
Risk Factors
Ophthalmology
medicine
Humans
Single-Blind Method
Prospective Studies
Glaucoma Drainage Implants
Antihypertensive Agents
Intraocular Pressure
030304 developmental biology
Aged
Aged, 80 and over
0303 health sciences
Glaucoma medication
business.industry
Washout
Eye drop
Middle Aged
medicine.disease
eye diseases
Clinical trial
030221 ophthalmology & optometry
Visual Field Tests
Female
sense organs
Ophthalmic Solutions
business
Glaucoma, Open-Angle
Subjects
Details
- ISSN :
- 18791891
- Volume :
- 216
- Database :
- OpenAIRE
- Journal :
- American journal of ophthalmology
- Accession number :
- edsair.doi.dedup.....dff8fe692071bf7328e32630b8e2a3a8