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The More, the Better?: The Usefulness of Brimonidine as the Fourth Antiglaucoma Eye Drop
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology. The Eye Department, Höglandssjukhuset, Eksjö.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
2018 (English)In: Journal of glaucoma, ISSN 1057-0829, E-ISSN 1536-481X, Vol. 27, no 7, p. 643-646Article in journal (Refereed) Published
Abstract [en]

Purpose:The purpose of this article was to study the intraocular pressure (IOP)-lowering effect of adding brimonidine as the fourth antiglaucoma medication to a preexisting therapy of 3 topical drugs.

Methods:This was a retrospective, register-based, cohort study of medical records and computerized medical information comprising 1 county in Sweden. The main outcome measure was change in IOP after brimonidine addition. Short-term and long-term effects were evaluated.

Results:Of 4910 patients on antiglaucoma medication, 69 (1.4%) initiated a treatment with brimonidine as the fourth drug during 2014. Fifty-three patients were eligible for analysis. Forty-six patients tolerated the treatment. Among them, short-term IOP decreased by 17% (confidence interval, 10%-25%; P<0.001) after a mean of 46 days (SD, 50d). Twenty-eight patients, that is, 53% of the eligible, remained on unchanged therapy after a mean follow-up time of 368 days (SD, 61d). The long-term mean IOP decrease in this group was 20% (confidence interval, 11%-29%; P<0.0001). An IOP reduction of at least 20% was reached by 28 and 14 patients, in the short-term and long-term follow-ups, respectively.

Conclusions:Brimonidine has the potential to reduce the IOP significantly even when used as the fourth drug. In the short-term, half of the patients reached the target IOP reduction (20%). After 1 year, a quarter of the eligible patients had had a sustained, uneventful effect. Thus, brimonidine as the fourth adjunctive antiglaucoma drop seems a valuable option for a minority of patients.

Place, publisher, year, edition, pages
Wolters Kluwer, 2018. Vol. 27, no 7, p. 643-646
Keywords [en]
glaucoma, medical therapy, brimonidine, fourth drop, antiglaucoma drop
National Category
Ophthalmology
Identifiers
URN: urn:nbn:se:umu:diva-150735DOI: 10.1097/IJG.0000000000000987ISI: 000438232700018PubMedID: 29762267OAI: oai:DiVA.org:umu-150735DiVA, id: diva2:1242244
Available from: 2018-08-27 Created: 2018-08-27 Last updated: 2018-08-27Bibliographically approved

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Bro, TomasLinden, Christina

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