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Adding carbonic anhydrase inhibitor to prostaglandin therapy may yield less diurnal IOP fluctuation

Br J Ophthalmol. 2010;94(10):1307-1311.

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The addition of dorzolamide hydrochloride to therapy with bimatoprost may result in less diurnal IOP fluctuation and improve vascular resistance in the ophthalmic artery.

In a prospective, single-masked study, 25 patients with primary open-angle glaucoma were treated with a morning dose of Lumigan (bimatoprost, Allergan). One eye of each patient was randomly chosen to receive twice-daily Trusopt (dorzolamide hydrochloride ophthalmic solution, Merck).

At baseline, mean IOP measured 14.8 mm Hg, and after 2 months, there was no significant difference between the monotherapy group and the dorzolamide group (12.8 mm Hg vs. 12.2 mm Hg). However, 24-hour fluctuations were significantly lower among eyes treated with the adjunctive medication (4.6 mm Hg) compared with eyes in the monotherapy group (6 mm Hg).

Variance analysis showed a significant decrease of vascular resistance in the ophthalmic artery among eyes treated with the adjunctive medication, the study authors said.