This article is more than 5 years old. Information may no longer be current.
Meta-analysis shows latanoprost effective for angle-closure glaucoma
Click Here to Manage Email Alerts
Researchers evaluated the results of 17 studies involving 807 patients and determined that latanoprost as monotherapy effectively reduced intraocular pressure in those with angle-closure glaucoma.
Chen and colleagues stated in Journal of Glaucoma that the treatment of choice for angle-closure glaucoma has been laser peripheral iridectomy or surgery to resolve the mechanical blockage.
“Several studies have demonstrated the efficacy and safety of latanoprost in patients with angle-closure glaucoma,” they wrote. “Although nonrandomized controlled trials typically reflect drug use in the real-world setting, existing meta-analyses have only included results from randomized controlled trials.”
The authors stated that all published trials, including randomized controlled trials and quasi-randomized controlled trials, were included in their analysis. They noted that aside from two non-Asian populations from Australia and Peru, the 13 countries included in the study were from Asia.
“We evaluated the effectiveness of latanoprost in treating angle-closure glaucoma in a relatively comprehensive way,” the authors said in the study.
They added that all of the trials were postmarketing studies.
The researchers found that latanoprost reduced mean IOP by 7.9 mm Hg (32.4%), peak IOP by 7.4 mm Hg (29.8%) and trough IOP by 7.9 mm Hg (32.5%). They also found that the most frequently reported ocular adverse effects were ocular hyperemia (9.4%), discomfort (8.7%) and blurred vision (5.2%). Systemic adverse effects included rhinitis, dizziness, headache and nonspecific skin pigmentation.
“In view of these favorable effects, future research can seek to investigate the efficacy of latanoprost in patients with complete angle-closure glaucoma,” the researchers concluded.
Disclosures: This analysis was supported by Pfizer Inc. Moh-Lim Ong, MD, MPH, and Zhong Zheng, MD, are employees of Pfizer. The remaining authors have no relevant financial disclosures.
Perspective
Back to Top
Carl H. Jacobsen, OD, FAAO
Latanoprost lowers IOP by about 30%, and the most common negative effect is ocular irritation. Nothing new here, right? Well, Chen et al., in their carefully performed meta-analysis of 17 studies, have determined that this is not only the case for patients with open-angle glaucoma, but it also holds true for patients with angle-closure glaucoma.
Treatment of angle-closure glaucoma is a real challenge that is rarely limited to a peripheral iridotomy (PI). While PI will at times restore a normal anatomic configuration and normalize eye pressure, more often aqueous drainage remains partially obstructed and elevated eye pressure persists.
Historically, we have thought that these patients do not respond well to topical medications, are contraindicated for laser glaucoma procedures and are more likely to need filtering surgery. While this is most certainly still the case, it is heartening to learn that latanoprost can have a significant IOP-lowering effect in patients with angle-closure glaucoma. With this understanding, perhaps clinicians will make more of an effort to treat these patients medically and use filtering procedures as a last resort.
Click Here to Manage Email Alerts