Purpose: Prospective evaluation of: I. IOP-change during a 12 week therapy
in patients so far untreated, in replacement therapy and in adjunctive
treatment, II. frequency of family history of glaucoma (FHG) and cardiac
diseases. Methods: Prospective
three months follow up of 6063 glaucoma patients by 404 ophthalmologists in
Germany. The physicians decided whether the patients received bilateral
brimonidine (bid) in an initial mono-, adjunctive or in a replacement-therapy.
IOP-measurements were performed before and 1, 4 and 12 weeks after change of
therapy. Results: I. Monotherapy led to a significant (p< 0.001) IOP
reduction after 12 weeks in respect to the untreated baseline of 25.6% in 268
patients with ocular hypertension (OH), 27.6% in 1092 patients with
primary-open-angle-glaucoma (POAG) and 18.9% in 64 patients with low-tension-glaucoma
(LTG). The additional IOP-decrease in combination with Dorzolamid was 24.2%,
with Betaxolol 20.4%, Latanoprost 17.2%,
Timolol 21.8%, Clonidin 25.8% and with Pilocarpine 25.6% (p<0,0001)
II. There was no significant difference in the IOP-lowering effect between
patients with (n=990) and without (n=3944) FHG. The probability of a cardiac
disease at defined ages was not different in different glaucomas. Conclusions:
Brimonidine showed an increasing IOP-lowering effect during the 12 weeks observation
time. Patients with FHG have no worse prognosis for treatment success than
patients without FHG. Cardiac risk factors are significant in all types of
glaucoma.
Acknowledgement: This study was supported by Pharm-Allergan, Germany