Influence of Travoprost 0.004% and Latanoprost 0.005% on Retinal Vascular Diameter and Choroidal Blood Flow in Glaucoma Patients
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 发起方
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- effect on choroidal blood flow
研究概览
简要总结
Vasoactivity of topical drugs may be of prognostic relevance in glaucoma. There is very little information for a major class, the prostaglandin analogues with regard to this aspect. The purpose of this study is to compare the effect of travoprost 0.004% and latanoprost 0.005% on choroidal blood flow and retinal vascular diameter in glaucoma patients. After washout of current topical medication, intraocular pressure (IOP) in both eyes (Goldmann applanation tonometry), choroidal blood flow (laser Doppler flowmetry) and retinal vessel diameter (Retinal Vessel Analyzer) in one randomly selected eye will be measured at baseline, after two weeks and after 4 weeks of treatment with travoprost or latanoprost QD, in a randomized, double masked 2-way cross-over study in 20 open angle glaucoma patients.
详细描述
Background Glaucoma is a leading cause of blindness worldwide. Chronic primary open-angle glaucoma is the most common form among Caucasian patients. The key feature of glaucoma is damage to the optic nerve head, which is not necessarily related to an increase in intraocular pressure (IOP). The actual therapeutic armamentarium for glaucoma includes miotics, beta-blockers, alpha-adrenergic agonists, oral and topical carbonic anhydrase inhibitors, and prostaglandin analogues, the latter being the latest addition to the armamentarium and the most potent topical IOP lowering drugs. Besides IOP, ocular blood flow alterations have been incriminated in glaucoma. Hence, it is of relevance to assess the effect of anti-glaucomatous drugs on ocular blood flow.
Rationale of the study Vasoactivity of topical drugs may be of prognostic relevance in glaucoma. There is very little information for a major class, the prostaglandin analogues with regard to this aspect. The vascular activity of two prostaglandin analogues, travoprost 0.004% and latanoprost 0.005%, which are already on the Swiss market, will be tested.
Study objectives Primary Objective: To assess the effect of two prostaglandin analogues, travoprost 0.004% and latanoprost 0.005% on choroidal blood flow in primary open-angle glaucoma patients.
Secondary Objective: To assess the effect of travoprost 0.004% and latanoprost 0.005% on retinal vascular diameter in primary open-angle glaucoma patients.
Investigational plan Primary open-angle-glaucoma patients will be assessed regarding inclusion/exclusion criteria. After a washout of current topical medication (beta-blockers and prostaglandin analogues: 4 weeks; topical carbonic anhydrase inhibitors and alpha-agonists: 2 weeks; Pilocarpine: 1 week), half of the patients (17 patients) will be treated with travoprost 0.004% for 1 month while the other 17 patients will be treated with latanoprost 0.005% for the same duration. Efficacy and safety variables will be assessed at baseline, after 2 weeks, and after 1 month of treatment. After this first period, the patients will be washed out for 4 weeks and baseline efficacy and safety parameters will be obtained. Afterwards, the patients will be treated with the other compound. Again, efficacy and safety variables will be assessed after 2 weeks and after 1 month of treatment.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 55 Years 至 85 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients fulfilling two out of three of the following criteria in one or both eyes: a) typical glaucomatous disc, b) visual field damage (a cluster of three points (except rim points) in at least one hemifield reduced by 5 dB or greater and including at least one point reduced by 10 dB or greater; a cluster of two points reduced by 10 dB or greater; or three adjacent points on the nasal horizontal meridian that differed by 5 dB or greater from their mirror points on the opposite side of the meridian), c) intraocular pressure above 21 mm Hg at least at one occasion after washout. No closed iridocorneal angles, evidence of secondary glaucoma, pseudoexfoliation, pigmentary dispersion, or any form of retinal or neuroophthalmologic disease that could result in visual field defects. No history of drug or alcohol abuse.
排除标准
- •Best corrected visual acuity worse than 2/10 in either eye < 0.2 Snellen. Inadequate transparency of ocular media as defined by physical examination. Severe central field loss defined as a sensitivity < 10dB in at least 2 of the 4 visual field test points closest to the point of fixation. Any abnormality which in the physician's view would prevent reliable applanation tonometry or LDF of both eyes, including an ametropia >3 dpt. History of chronic or recurrent severe inflammatory eye disease such as scleritis or uveitis. History of ocular trauma or intraocular surgery within the past 6 months. History of infection or inflammation within the past 3 months. History of clinically significant or progressive retinal disease such as retinal degeneration, diabetic retinopathy or retinal detachment. A known hypersensitivity to the compounds tested. Need for any concomitant medications that may interfere with the evaluation of ocular blood flow. Variability > 30 % during Laser Doppler Flowmetry (sample of 6 measurements) in both eyes. Pregnancy, breastfeeding, or women in childbearing age without adequate contraception.
研究组 & 干预措施
2
cross-over comparison of two substances
干预措施: latanoprost 0.005% (drug) (Drug)
1
干预措施: travoprost 0.004% (drug) (Drug)
结局指标
主要结局
effect on choroidal blood flow
时间窗: baseline - 2 weeks - 4 weeks
次要结局
- effect on retinal vascular diameter(baseline - 2 weeks - 4 weeks)