[Ocular hypotensive effect of systemic beta-blockers in patients with primary glaucoma and arterial hypertension].

Vestn Oftalmol

Novokuznetsk State Institute of Postgraduate Medicine, Ministry of Health of the Russian Federation, 5 Stroiteley prospekt, Novokuznetsk, Kemerovo Oblast, Russian Federation, 654005.

Published: April 2018

AI Article Synopsis

  • The study aimed to assess the effectiveness of systemic beta-blockers in lowering eye pressure in primary open-angle glaucoma (POAG) patients who also have arterial hypertension.
  • 29 patients participated, receiving a combination of treatments including beta-blockers, with significant follow-ups to measure intraocular pressure (IOP) changes over one year.
  • Results showed a notable decrease in IOP, with the worst affected eyes showing reductions of 14% at 4 weeks and up to 26% at one year, suggesting beta-blockers can be a viable option for managing both conditions and minimizing medication side effects.

Article Abstract

Aim: to evaluate the ocular hypotensive efficacy of systemic beta-blockers in primary glaucoma patients suffering from arterial hypertension (AH).

Material And Methods: The study included 29 patients with POAG (58 eyes) aged from 47 to 83 years. Patients with stage I-III POAG received instillations of prostaglandin analogs and carbonic anhydrase inhibitors. All POAG patients also suffered from arterial hypertension and were prescribed selective beta-blockers (metoprolol, bisoprolol, or nebivalol) as monotherapy or as part of combination therapy (if the target arterial pressure had not been achieved under the initial treatment). After the start of oral beta-blockers therapy, the patients were re-examined at 2 and 4 weeks, 3 months, 6 months, and 1 year.

Results: A clinically significant reduction of IOP in the most seriously affected eye - by 3.3 mmHg (p<0.05), or 14% - occurred four weeks after the start of selective beta-blockers. Over three months of combination therapy, IOP in the 'worst' eye decreased by 4.4 mmHg (18.5%). At 1 year, IOP in the 'worst' eye was 6.2 mmHg (26%) lower than at baseline (p<0.05).

Conclusion: Aged and senile patients with primary glaucoma usually suffer from polypathy (on average, they have 6.3±0.6 concurrent somatic diseases). To reduce the risk of polypharmacy and the frequency of side effects in the treatment of POAG and AH patients, it is advised that the treatment includes oral selective beta-blockers able to provide target levels of arterial pressure and IOP. In this study, oral beta-blockers in POAG and AH patients enabled IOP reduction as great as 18.5%-26% of baseline values over a 1-year follow-up period.

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http://dx.doi.org/10.17116/oftalma2017133246-50DOI Listing

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