Md. Abul K.Chowdhury1, Mst. Tasnim Tabassum Chowdhury2,Jasim Uddin Ahmed 3,Parvej Mia4, Abdullah Sayed5, Nasrin Akter6
1. Assistant Professor, Department of Pharmacology, North East Medical College, Sylhet
2. Lecturer, Department of Community Medicine, North East Medical College, Sylhet
3. Assistant Professor, Department of Ophthalmology, Chattogram International Medical College Hospital
4. Registrar, Department of Medicine, North East Medical College, Sylhet
5. Assistant Professor, Department of Psychiatry, North East Medical College, Sylhet
6. Associate Professor, Department of Pharmacology, North East Medical College, Sylhet
Abstract
Primary open angle glaucoma is a significant public health problem in Bangladesh. Both Latanoprost and Brimonidine are now widely used in the treatment of primary open angle glaucoma (POAG). Nevertheless, there is scarcity of study regarding the efficacy and safety in Bangladeshi patient. This triple blind, multicenter, randomized clinical trial was conducted to compare the clinical efficacy and adverse effects & treatment outcome of Latanoprost once daily with Brimonidine twice daily as mono-therapy in patients with primary open angle glaucoma. The primary outcome measure was response rate, defined as the percentage of patients achieving 20 percent reduction in IOP from baseline to three months and secondary outcome measures were mean IOP reduction and ocular adverse effects of drug which were also assessed by patient’s history and slit lamp examination. A total number of 80 patients of primary open angle glaucoma were selected with the age ranging (40-90) years of both sexes. Patients were selected purposively and randomization was done by computer-generated random numbers. Group-A Patients were treated by topical Latanoprost one drop(1.5 g) once daily for three months and group-B Patients received topical Brimonidine one drop(1.5 g) twice daily for three months. The study parameters were IOP measurement and adverse effect were estimated in OPD of Ophthalmology in above mention three hospitals in Chattogram. Statistical analysis was done in the Department of Pharmacology, Chittagong Medical College. At three months mean IOP was 19.46±1.81 and 20.88±1.54 in Latanoprost and Brimonidine groups respectively and there was significant difference in IOP between two groups. Whereas, there was no significant difference in baseline IOP. After three months of treatment 39(97.5%) patients in the Latanoprost group and 33(82.5%) patients in the Brimonidine group had achieved 20 percent intraocular pressure reduction from baseline. There was significant difference in percentage of reduction of IOP between two groups. The result of this study demonstrated that Latanoprost taken once daily is more effective and safe in reducing IOP than Brimonidine twice daily.
Key Words: Latanoprost; Brimonidine, Open angle glaucoma, Intraocular pressure