The diurnal and nocturnal effect of travoprost with sofZia on intraocular pressure and ocular perfusion pressure

Abstract

Purpose: To determine the 24-hour effects of travoprost with sofZia on intraocular pressure (IOP) and ocular perfusion pressure as well as the endurance of IOP lowering after last dosing.

Design: Prospective, open-label study.

Methods: Forty subjects with open-angle glaucoma or ocular hypertension were admitted to our sleep laboratory for three 24-hour sessions monitoring IOP, blood pressure (BP), and heart rate. The first baseline session occurred after medication washout or immediately after enrollment for treatment-naïve patients. A second 24-hour monitoring session was performed after 4 weeks of once-nightly treatment of travoprost with sofZia. The medication was then discontinued and a third 24-hour session was completed 60-84 hours after the last dose taken. IOP measurements were taken using a pneumotonometer every 2 hours in the sitting position during the 16-hour diurnal period and in the supine position during the 8-hour nocturnal period. Ocular perfusion pressure was defined as 2/3[diastolic BP + 1/3(systolic BP - diastolic BP)] - IOP.

Results: Treatment with travoprost with sofZia significantly lowered mean diurnal and nocturnal IOP levels from baseline (diurnal 18.1 ± 3.9 to 15.3 ± 3.3 mm Hg; nocturnal 20.6 ± 3.6 to 19.4 ± 3.4 mm Hg, P < .01 for both). Once treatment was discontinued, mean IOP remained at levels significantly less than baseline during both the diurnal (16.6 ± 3.8 mm Hg) and nocturnal periods (19.4 ± 3.5 mm Hg). Mean baseline ocular perfusion pressure was significantly increased during the diurnal but not the nocturnal period (diurnal 73.7 ± 11.4 to 76.5 ± 10.3 mm Hg, P = .01; nocturnal 64.4 ± 12.6 to 64.2 ± 11.1 mm Hg, P = .67).

Conclusion: Travoprost with sofZia significantly lowers IOP throughout the diurnal and nocturnal periods, and increases ocular perfusion pressure in the diurnal, but not the nocturnal, period in open-angle glaucoma and ocular hypertension. The treatment effect on IOP endures for at least 84 hours after the last dose.

Trial registration: ClinicalTrials.gov NCT01779778.

Copyright © 2014 Elsevier Inc. All rights reserved.

Figures

Figure 1

Mean 24-hour intraocular pressure profiles in habitual body positions at baseline, during treatment with travoprost with sofZia, and after three missed doses. Circles represent baseline measurements off treatment, squares represent measurements during treatment with travoprost with sofZia, and triangles represent measurements after three missed doses of medication. Error bars represent the standard error of the mean.

Figure 2

Relationship of baseline intraocular pressure and absolute change of intraocular pressure with travoprost with sofZia. Pearson correlation coefficient = -0.80, p

Figure 3

Mean 24-hour ocular perfusion pressure profiles in habitual body positions at baseline, during treatment with travoprost with sofZia, and after three missed doses. Circles represent baseline measurements off treatment, squares represent measurements during treatment with travoprost with sofZia, and triangles represent measurements after three missed doses of medication. Error bars represent the standard error of the mean.