Long-term effects of timolol therapy in ocular hypertension : a double-masked, randomised trial
(2000) In Graefe's Archive for Clinical and Experimental Ophthalmology 238(11). p.83-877- Abstract
BACKGROUND: Increased intraocular pressure (IOP) has been shown to be one of the most important risk factors for developing glaucoma. Yet it has not been clearly demonstrated that IOP-lowering treatment can reduce the incidence of glaucoma damage in patients with ocular hypertension. The aim of the current paper was to report the results of a long-term study addressing this very problem.
METHODS: We conducted a randomised, double-masked study comparing timolol and placebo treatment in 90 patients with ocular hypertension plus some additional risk factor. Patients were followed at 3-month intervals prospectively for 10 years or until glaucomatous field loss could be demonstrated with computerised perimetry. A post-study analysis... (More)
BACKGROUND: Increased intraocular pressure (IOP) has been shown to be one of the most important risk factors for developing glaucoma. Yet it has not been clearly demonstrated that IOP-lowering treatment can reduce the incidence of glaucoma damage in patients with ocular hypertension. The aim of the current paper was to report the results of a long-term study addressing this very problem.
METHODS: We conducted a randomised, double-masked study comparing timolol and placebo treatment in 90 patients with ocular hypertension plus some additional risk factor. Patients were followed at 3-month intervals prospectively for 10 years or until glaucomatous field loss could be demonstrated with computerised perimetry. A post-study analysis was performed including all available data, thus extending maximum follow-up to 17 years.
RESULTS: After 5 years of follow-up eight patients in the placebo group and five patients in the timolol group had developed glaucomatous field loss (NS); the corresponding figures after 10 years were 15 patients in the placebo group and seven patients in the timolol group. Survival analysis showed a tendency but no statistically significant difference between treatment groups (P = 0.07). Study attrition was large. Eighteen patients in each group had developed glaucomatous field loss when also post-study data were included. IOP reduction was greater in eyes passing the 10-year visit without field loss (5.7 mmHg), than in those that reached an end-point (2.3 mmHg; P = 0.0002).
CONCLUSION: In this long-term study we found a tendency but failed to prove a beneficial effect of topical timolol treatment in patients with elevated IOP, normal visual fields and some additional risk factor. The intent-to-treat analysis showed no difference between treatment groups. The high attrition shows the difficulties associated with very long follow-up.
(Less)
- author
- Heijl, A LU and Bengtsson, B LU
- organization
- publishing date
- 2000-11
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adrenergic beta-Antagonists, Double-Blind Method, Female, Follow-Up Studies, Humans, Intraocular Pressure, Male, Middle Aged, Ocular Hypertension, Optic Disk, Prospective Studies, Risk Factors, Timolol, Tonometry, Ocular, Treatment Outcome, Visual Fields
- in
- Graefe's Archive for Clinical and Experimental Ophthalmology
- volume
- 238
- issue
- 11
- pages
- 7 pages
- publisher
- Springer
- external identifiers
-
- pmid:11148810
- scopus:0033748355
- ISSN
- 0721-832X
- DOI
- 10.1007/s004170000189
- language
- English
- LU publication?
- yes
- id
- 3dabe970-f961-438d-9982-2e9e5d23e54a
- date added to LUP
- 2016-08-30 16:50:56
- date last changed
- 2023-09-11 23:10:55
@article{3dabe970-f961-438d-9982-2e9e5d23e54a,
abstract = {{<p>BACKGROUND: Increased intraocular pressure (IOP) has been shown to be one of the most important risk factors for developing glaucoma. Yet it has not been clearly demonstrated that IOP-lowering treatment can reduce the incidence of glaucoma damage in patients with ocular hypertension. The aim of the current paper was to report the results of a long-term study addressing this very problem.</p><p>METHODS: We conducted a randomised, double-masked study comparing timolol and placebo treatment in 90 patients with ocular hypertension plus some additional risk factor. Patients were followed at 3-month intervals prospectively for 10 years or until glaucomatous field loss could be demonstrated with computerised perimetry. A post-study analysis was performed including all available data, thus extending maximum follow-up to 17 years.</p><p>RESULTS: After 5 years of follow-up eight patients in the placebo group and five patients in the timolol group had developed glaucomatous field loss (NS); the corresponding figures after 10 years were 15 patients in the placebo group and seven patients in the timolol group. Survival analysis showed a tendency but no statistically significant difference between treatment groups (P = 0.07). Study attrition was large. Eighteen patients in each group had developed glaucomatous field loss when also post-study data were included. IOP reduction was greater in eyes passing the 10-year visit without field loss (5.7 mmHg), than in those that reached an end-point (2.3 mmHg; P = 0.0002).</p><p>CONCLUSION: In this long-term study we found a tendency but failed to prove a beneficial effect of topical timolol treatment in patients with elevated IOP, normal visual fields and some additional risk factor. The intent-to-treat analysis showed no difference between treatment groups. The high attrition shows the difficulties associated with very long follow-up.</p>}},
author = {{Heijl, A and Bengtsson, B}},
issn = {{0721-832X}},
keywords = {{Adrenergic beta-Antagonists; Double-Blind Method; Female; Follow-Up Studies; Humans; Intraocular Pressure; Male; Middle Aged; Ocular Hypertension; Optic Disk; Prospective Studies; Risk Factors; Timolol; Tonometry, Ocular; Treatment Outcome; Visual Fields}},
language = {{eng}},
number = {{11}},
pages = {{83--877}},
publisher = {{Springer}},
series = {{Graefe's Archive for Clinical and Experimental Ophthalmology}},
title = {{Long-term effects of timolol therapy in ocular hypertension : a double-masked, randomised trial}},
url = {{http://dx.doi.org/10.1007/s004170000189}},
doi = {{10.1007/s004170000189}},
volume = {{238}},
year = {{2000}},
}