An observational study on the effectiveness & safety of anti-glaucoma medications in treatment naive patients of primary open angle glaucoma

Aditi Maitra, Shashwat Bhattacharyya, Kumaresh Chandra Sarkar, Shatavisha Mukherjee, Sambuddha Ghosh, Santanu Kumar Tripathi


Background: The paradox of open angle glaucoma therapy lies in the loss of reported efficacy of drugs when they are studied for real world effectiveness. Studies related to effectiveness and safety done in a longitudinal fashion in new cases of open angle glaucoma are scant. This study was undertaken to address
the shortcomings in this regard.
Materials and Methods: This was an open label, prospective, observational study. The patients were taken up for the study at their baseline visit and 3 subsequent follow up visits for next 6 months. The effectiveness was gauged on the basis of average IOP changes from baseline. Each patient was administered
questionnaires for ocular surface disease and interviewed for possible adverse drug reactions at each follow up.
Results: There were 68 participants who completed the study. All these patients reported at baseline and 3 subsequent follow ups. The mean baseline IOP was 27.20 (SD 6.29) mm of Hg and this reduced considerably to 16.97 mm of Hg (SD 3.18) which was a 37.61% reduction from the baseline (p < 0.05). The best reductions of IOP were noted in prostaglandin analog & blockers either in fixed dose combinations. There were 37 episodes of adverse drug reactions reported. All of them were definitely preventable and mild in severity.
Conclusions: The prostaglandin analogs remain the most important anti glaucoma drugs as far as effectiveness is concerned. The safety profile of most of the drugs was marred by deterioration the ocular surface disease score. The use of preservatives was also associated with statistically significant worsening.

Keywords: safety, Antiglaucoma drugs, Effectiveness, Ocular surface Prostaglandin analogs.

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