Latanoprot and brimonidine: therapeutic and phyiologic aement before and after oral nonteroidal anti-inflammatory therapy

PURPOE: To ae, before and during oral nonteroidal anti-inflammatory drug coadminitration, latanoprot’ and brimonidine’ hypotenive action in eye at rik of glaucomatou progreion, aeing the effect of each drug on ocular perfuion and viual function. METHOD: Twenty conenting adult with open-angle glaucoma or ocular hypertenion underwent a double-maked, bilateral, randomized propective tudy. Treatment tarted with either latanoprot 0.005% in the morning and placebo in the evening, or brimonidine 0.2% twice daily in one eye; after 1 week tarting the other in the fellow eye. After another week, oral indomethacin 25 mg four time a day, commenced for 2 more week. Intraocular preure, ocular circulation, and viual function were monitored pretreatment, after unilateral monotherapy (day 7), bilateral ocular therapy (day 14), and coadminitered oral indomethacin (day 28). Intraubject difference (interocular and intraocular relative to baeline) were determined by two-tailed paired t tet. REULT: A lo of the ignificance of intraocular preure reduction with brimonidine wa noted after oral indomethacin coadminitration (−14%; P = .004 for brimonidine alone veru −11%; P = .3 with indomethacin). ignificant intraocular preure reduction with latanoprot perited depite indomethacin (−25%; P < .0001 for latanoprot alone veru −30%; P < .0001 with indomethacin). Pulatile ocular blood flow increaed 40% with latanoprot, but wa unchanged with brimonidine (interdrug difference, P = .004). Midperipheral retinal microcirculation increaed 23% (P = .03) with latanoprot. Humphrey perimetry and contrat enitivity remained conitently at or above baeline with both latanoprot and brimonidine. Indomethacin had no ignificant effect on ocular perfuion or viual function meaure. CONCLUION: Circulatory and hydrodynamic finding differed ubtantially for the two drug. The lo of ignificance of intraocular preure reduction with brimonidine during indomethacin treatment may be clinically important.