Brimonidine as an additional treatment for moderate glaucoma

Abstract

I.R. Gazizova1, V.E. Korelina2,3 1N.P. Bekhtereva Institute of the Human Brain, Saint Petersburg, Russian Federation 2LLC “American Medical Clinic”, Saint Petersburg, Russian Federation 3I.I. Mechnikov North-Western State Medical University, Saint Petersburg, Russian Federation Aim: to assess the utility of brimonidine 0.2% as an additional IOP-lowering treatment for moderate glaucoma. Patients and Methods: 99 patients (121 eyes) aged 62–73 years with moderate glaucoma were enrolled. All patients were divided into four groups based on IOP-lowering medications. In group 1, prostaglandin analogues (latanoprost) and beta blockers (timolol) were prescribed. In group 2, carbonic anhydrase inhibitors (dorzolamide) and beta blockers (timolol) were prescribed. In group 3, brimonidine 0.2% was added to prostaglandin analogues and beta blockers. In group 4, brimonidine 0.2% was added to carbonic anhydrase inhibitors and beta blockers. All patients underwent IOP measurements and static automated perimetry (SAP) at baseline and after 6 and 12 months. Results: additional treatment (brimonidine) gradually reduced IOP levels in groups 3 and 4, while in groups 1 and 2 IOP levels were stable. In group 1, mean deviation (MD) increased from -10.7±4.5dB to -10.8±3.8 dB after 6 months but reduced to -10.5±3.4 dB after 12 months. In group 2, MD increased from -11.7±5.1 dB to -12.0±3.2 dB after 6 months and -12.5±2.9 dB after 12 months. In group 3, MD reduced from -13.5±4.1 dB to -12.9±3.6 dB after 6 months and -12.7±3.0 dB after 12 months. In group 4, MD reduced from -13.9±4.6 dB to -13.0±4.1 dB after 6 months and increased to -13.1±3.5 dB after 12 months. Pattern standard deviation (PSD) was stable in all four groups. Conclusion: brimonidine as an additional treatment for moderate and advanced glaucoma results in stable IOP reduction. Combined therapy which includes brimonidine preserves visual functions even in moderate-to-advanced glaucoma. The neuroprotective effect of brimonidine is illustrated by SAP. This medication is well tolerated. Keywords: glaucoma, IOP, visual field, perimetry, tonometry, neuroprotection. For citation: Gazizova I.R., Korelina V.E. Brimonidine as an additional treatment for moderate glaucoma. Russian Journal of Clinical Ophthalmology. 2021;21(2):69–71. DOI: 10.32364/2311-7729-2021-21-2-69-71.