Long-term outcomes of prostaglandin analog versus timolol maleate in ocular hypertensive or primary open-angle glaucoma patients in Europe

PURPOSE

To determine the direct costs of therapy over 5 years of a European monotherapy cohort begun on a prostaglandin (PTG) versus timolol in patients with primary open-angle glaucoma or ocular hypertension.

METHODS

A retrospective, multicenter, active-controlled, observational study. Data were abstracted for European patients treated as initial monotherapy in 1996 or afterward, with 5 years of available records.

RESULTS

This study included 271 patients (166 on a PTG and 105 on timolol at baseline). The average cost/month/patient over 5 years was $45.47±12.61 for PTG and $31.50±15.47 for timolol (P<0.001, based on German prices). After 5 years, although there was no difference in number of glaucoma medicines prescribed between groups (1.0 PTGs and 1.1 timolol, P=0.41), the timolol group demonstrated a higher intraocular pressure (17.7±2.9 vs. 16.5±3.0 mm Hg, P<0.001), more medication changes (P=0.01), greater incidence of glaucomatous progression (P=0.04), and less patients persistent on original monotherapy (P<0.001) than the PTG cohort.

CONCLUSIONS

Patients originally on timolol monotherapy have a lower cost of care over 5 years than those started on a PTG. However, timolol patients during follow-up may demonstrate a higher intraocular pressure, more progression, more medication changes, and lower persistency of the original monotherapy.

[Evaluation of accuracy in diagnosis of intraocular tumors in personal material from 1985-1994]

AIM

Assessment of the correlation between the clinical diagnosis of intraocular tumor and anatomopathologic findings.

MATERIAL AND METHODS

Retrospective analysis of the results of the treatment in the groups of adults and children during the period of 1985-1994.

RESULTS

In all 35 cases of adults melanoma malignum was diagnosed and confirmed anatomopathologically. In 7 among 20 children the appearance of tumor was not confirmed by anatomopathologic findings.

CONCLUSIONS

Special attention should be paid to the improvement of intraocular tumor diagnosis, particularly in children.

An unusual pedigree with microcornea-cataract syndrome

A pedigree with 14 patients affected with microcornea-cataract (MC) syndrome is described. MC syndrome is very rare and this pedigree is probably the sixth to be reported. Transmission is most likely autosomal dominant, but the unusual feature of the present family is the fact that the proportion of affected members is so high that one is tempted to suspect preferential transmission of the chromosome carrying the MC gene.

[Artificial intraocular lenses in patients with cataracts and glaucoma]

The authors evaluated 52 glaucomatous eyes in which, after the extracapsular cataract extraction, artificial posterior lens has been implanted. In 32 patients glaucoma has been treated for 2-6 years. In 7 patients of this group, it was not possible to control the intraocular pressure before surgery and in these cases simultaneous trabeculectomy, extracapsular cataract extraction and the implantation of artificial posterior lens were performed. In 13 patients, anti-glaucomatous surgery had been performed before, and in 7 cases, glaucoma was diagnosed in the preoperative period. We considered our results as satisfactory since in 67% visual acuity was over 0.5; 29% of the patients did not require anti-glaucomatous treatment, whereas 71% took anti-glaucomatous drugs in reduced doses. In our opinion, glaucoma is not a contraindication for artificial lens implantation, although surgery can be technically more difficult.

[Late results of the treatment of eye burns]

An analysis of patients treated in the Ophthalmic Department in Bydgoszcz for eye burns in the 10 years period from 1980 till 1990. Taken into account were the causes of burns, the treatment installed in the early period and in cases of late complications. All the patients were asked to call in for a control examination in order to compare the condition of the eyes at the date of discharge and in the long-lasting time. Among 118 eyes in 91 the visual acuity amounted 0.5-1.0, in the remaining 25 it was only hand movements--0.4. The main causes of low visual acuity were: corneal leucoma, secondary glaucoma, complicated cataract. The eye was enucleated in 2 patients because a painful ocular atrophy developed in the course of the pathological process. These were the cases of thermal burns combined with a mechanical injury. The obtained results were evaluated as sufficiently favourable and comparable to the data of other authors.