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Trial gauges true IOP-lowering effect of prostaglandin therapy
Ophthalmology. 2011;118(11):2190-2195.
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A monocular trial proved more accurate than the conventional method in estimating the true therapeutic effect of prostaglandin monotherapy in untreated eyes, a study found.
"The most reliable method for assessing effectiveness is by performing a series of pre- and post-treatment IOP measurements, but in practice this has obvious resource implications," the study authors said. "The monocular (or uniocular) trial of therapy has been advocated as a useful way around this problem. In this approach, treatment is begun in only one eye and the change in IOP relative to the untreated fellow eye is used as the measure of effectiveness. In this way, the untreated eye is used to control for the effect of spontaneous fluctuation without requiring additional IOP measurements."
The prospective study included 30 patients. Mean patient age was 64.4 years.
IOP was measured in both eyes at 11 a.m. for 7 consecutive weeks. Travoprost 0.001% was initiated in the eye with the higher IOP at 3 weeks and in the fellow eye at 4 weeks.
Unadjusted IOP-lowering effect, adjusted IOP-lowering effect and true therapeutic effect were measured for trial eyes.
Study results showed that IOP diminished by 2.4 mm Hg in trial eyes and 3.3 mm Hg in fellow eyes. Reductions in IOP correlated significantly between the two eyes.
Data showed that the unadjusted treatment effect overestimated the true effect by a mean of 3.1 mm Hg.