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Clinical Efficacy of Topical Nipradilol and Timolol on Visual Field Performance in Normal- Tension Glaucoma: a Multicenter

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Clinical Efficacy of Topical Nipradilol and Timolol on Visual Field Performance in Normal- Tension Glaucoma: a Multicenter See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/23239339 Clinical efficacy of topical nipradilol and timolol on visual field performance in normal- tension glaucoma: A multicenter... Article in Japanese Journal of Ophthalmology · August 2008 DOI: 10.1007/s10384-008-0540-z · Source: PubMed CITATIONS READS 9 38 5 authors, including: Shiroaki Shirato Yasuo Ohashi SHIRATO EYE CLINIC Chuo University 139 PUBLICATIONS 2,929 CITATIONS 809 PUBLICATIONS 22,237 CITATIONS SEE PROFILE SEE PROFILE Some of the authors of this publication are also working on these related projects: Treatment of osteoporosis View project Chemotherapy Induced Neurotoxicity View project All content following this page was uploaded by Yasuo Ohashi on 25 January 2014. The user has requested enhancement of the downloaded file. 60) Clinical efficacy of topical nipradilol and timolol on visual field performance in normal-tension glaucoma: a multicenter, randomized, double-masked comparative study. Araie M , Shirato S , Yamazaki Y , Kitazawa Y , Ohashi Y ; Nipradilol-Timolol Study Group . Collaborators (55) Shirato S , Yamazaki Y , Araie M , Matsumoto C , Shirato S , Yamazaki Y , Araie M , Ohashi Y , Hamada C , Kitazawa Y , Ohashi Y , Hara T , Hashimoto T , Tsuru T , Kojima T , Tomidokoro A , Nakajima F , Obata R , Yamazaki Y , Nakagami T , Hayamizu F , Yamagami J , Suzuki J , Kishimoto S , Oshima Y , Nakayama K , Otake Y , Kimura I , Tanino T , Shirato S , Haneda M , Kimura T , Kawabata K , Yasuda N , Nakamoto K , Matsumoto S , Yoshimoto M , Suzumura H , Tomita G , Suzuki Y , Tomidokoro A , Kunimatsu S , Nakano T , Shirato S , Maruyama K , Inoue T , Kouzaki A , Inoue Y , Suzumura H , Yoshikawa K , Miyata H , Shirakashi M, Kashiwagi K , Iwase A , Shono Y . Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan. [email protected] PURPOSE: To compare the effects of topical nipradilol and timolol on the visual field in Japanese normal-tension glaucoma (NTG) patients. METHODS: We enrolled 146 NTG patients. At baseline, age, intraocular pressure (IOP), and mean deviation (MD) by the Humphrey field analyzer were 47.6 (SD 8.5), 14.2 (1.7) mmHg, and -4.5 (3.0) dB. Seventy-two patients were randomly assigned to the 0.25% nipradilol group and 74 patients to the 0.5% timolol ophthalmic solution group twice daily for the 3-year study period. The Humphrey full-threshold 30-2 visual field test was performed every 6 months. The primary end point was the nonparametric O'Brien summary score (sum of the ranks of six slopes calculated from the average of the total deviation in each cluster) in each patient. The secondary analyses were differences in the MD slope, average of the total deviation in each cluster, the corrected pattern standard deviation (CPSD), and the time course of IOP. RESULTS: No significant intergroup differences were found in baseline characteristics, or in the parameters of the primary and secondary analyses. In both groups, central superior clusters showed negative slopes and IOP decreased by about 1 mmHg from baseline. CONCLUSION: No significant difference in visual field performance or IOP reduction was seen between the nipradilol and timolol groups. PMID: 18773262 [PubMed - indexed for MEDLINE] 61) Contribution of TRPV1 to microglia-derived IL-6 and NFkappaB translocation with elevated hydrostatic pressure. Sappington RM , Calkins DJ . Department of Ophthalmology and Visual Sciences, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee 37232-0654, USA. PURPOSE: The authors investigated the contributions of the transient receptor potential vanilloid-1 receptor (TRPV1) and Ca(2+) to microglial IL-6 and nuclear factor kappa B (NFkappaB) translocation with elevated hydrostatic pressure. METHODS: The authors first examined IL-6 colocalization with the microglia marker Iba-1 in the DBA/2 mouse model of glaucoma to establish relevance. They isolated microglia from rat retina and maintained them at ambient or elevated (+70 mm Hg) hydrostatic pressure in vitro and used ELISA and immunocytochemistry to measure changes in the IL-6 concentration and NFkappaB translocation induced by the Ca(2+) chelator EGTA, the broad-spectrum Ca(2+) channel inhibitor ruthenium red, and the TRPV1 antagonist iodo-resiniferatoxin (I-RTX). They applied the Ca(2+) dye Fluo-4 AM to measure changes in intracellular Ca(2+) at elevated pressure induced by I-RTX and confirmed TRPV1 expression in microglia using PCR and immunocytochemistry. RESULTS: In DBA/2 retina, elevated intraocular pressure increased microglial IL-6 in the ganglion cell layer. Elevated hydrostatic pressure (24 hours) increased microglial IL-6 release, cytosolic NFkappaB, and NFkappaB translocation in vitro. These effects were reduced substantially by EGTA and ruthenium red. Antagonism of TRPV1 in microglia partially inhibited pressure-induced increases in IL-6 release and NFkappaB translocation. Brief elevated pressure (1 hour) induced a significant increase in microglial intracellular Ca(2+) that was partially attenuated by TRPV1 antagonism. CONCLUSIONS: Elevated pressure induces an influx of extracellular Ca(2+) in retinal microglia that precedes the activation of NFkappaB and the subsequent production and release of IL-6 and is at least partially dependent on the activation of TRPV1 and other ruthenium red-sensitive channels. PMID: 18362111 [PubMed - indexed for MEDLINE] 62) A comparison of visual field progression criteria of 3 major glaucoma trials in early manifest glaucoma trial patients. Heijl A , Bengtsson B , Chauhan BC , Lieberman MF , Cunliffe I , Hyman L , Leske MC . Department of Ophthalmology, Lund University, Malmö University Hospital, Malmö, Sweden. [email protected] PURPOSE: Three major glaucoma trials, all using the same Humphrey visual field tests, specified different criteria to define visual field progression. This article compares the performance of these criteria with a reference standard of unanimous classifications by 3 independent glaucoma experts. DESIGN: Longitudinal, comparative study of diagnostic criteria. PARTICIPANTS AND CONTROLS: Two hundred forty-five patients with manifest glaucoma in the Early Manifest Glaucoma Trial (EMGT). METHODS: Visual field series of 1 eye of each of 245 EMGT patients were classified by 3 independent glaucoma specialists as definitely progressing, definitely nonprogressing, or neither. Field series that were classified in the first 2 categories by all 3 experts met the reference standards for the progressing and nonprogressing groups and were analyzed according to the progression criteria of the Advanced Glaucoma Intervention Study (AGIS), the Collaborative Initial Glaucoma Treatment Study (CIGTS), and the EMGT. Sensitivity, specificity, time to progression, and sustainability were calculated. MAIN OUTCOME MEASURES: Progression, nonprogression, sensitivity, specificity, time to progression, and sustainability. RESULTS: Seventy-seven field series were definitely progressing, and 95 series were definitely nonprogressing. Among progressing eyes, 45 (58%) of 77 were identified using AGIS criteria, 58 (75%) of 77 were identified with CIGTS criteria, and 74 (96%) of 77 were identified with EMGT criteria; all comparisons of sensitivities were significant, simultaneous (P<0.001), and pairwise (P<0.01). The specificity for EMGT criteria was 89%, lower (P<0.05) than that of AGIS (98%) and CIGTS (99%) criteria. Median time to progression was considerably shorter with EMGT criteria (33 months; 95% confidence interval [CI], 30-36 months) than with AGIS (66 months; 95% CI, 57-78 months) and CIGTS (55 months; 95% CI, 48-66 months) criteria. Sustainability increased with time after progression; it averaged 79%, 84%, and 81%, respectively, for AGIS, CIGTS, and EMGT criteria during the first year after the first progression and 95%, 100%, and 93% during the fourth year after progression. CONCLUSIONS: The EMGT criteria identified progression earlier and more often than AGIS and CIGTS criteria. Specificity was good for all criteria but was better with AGIS and CIGTS than with EMGT criteria. Sustainability was high for all 3 sets of criteria and best for CIGTS criteria and increased with time after progression. PMID: 18378317 [PubMed - indexed for MEDLINE] 63) Ahmed valve implantation with adjunctive mitomycin C and 5-fluorouracil: long-term outcomes. Alvarado JA , Hollander DA , Juster RP , Lee LC . Department of Ophthalmology, Glaucoma Research Laboratory, University of California, San Francisco, San Francisco, California 94143, USA. [email protected] PURPOSE: To evaluate long-term outcomes after Ahmed valve implantation in patients with glaucoma when using adjunctive intraoperative mitomycin C (MMC) and postoperative 5-fluorouracil (5-FU). DESIGN: Retrospective, interventional, consecutive case series. METHODS: A consecutive series of eyes undergoing Ahmed valve implantation, either alone (AHMED eyes) or in combination with cataract surgery (AHMED+PHACO), using both intraoperative MMC and postoperative 5-FU were evaluated. Failure was defined as the first occurrence of any of the following: 1) the first of three consecutive visits where intraocular pressure (IOP) was >18 mm Hg or <20% IOP reduction from baseline and the final number of topical medications was not reduced by at least two from baseline, 2) the need for additional surgery, or 3) the development of serious complications. RESULTS: A total of 130 eyes underwent Ahmed
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