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Published in: BMC Ophthalmology 1/2017

Open Access 01-12-2017 | Research article

Long term safety and tolerability of Tafluprost 0.0015% vs Timolol 0.1% preservative-free in ocular hypertensive and in primary open-angle glaucoma patients: a cross sectional study

Authors: Teresa Rolle, Roberta Spinetta, Raffaele Nuzzi

Published in: BMC Ophthalmology | Issue 1/2017

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Abstract

Background

The effects of preservatives of antiglaucoma medications on corneal surface and tear function have been widely shown in literature; it’s not the same as regards the active compounds themselves. The purpose of our study was to compare Ocular Surface Disease (OSD) signs and symptoms of Tafluprost 0.0015% versus preservative free (PF) Timolol 0.1% eyedrops in ocular hypertensive (OH) and in primary open-angle glaucoma (POAG) patients.

Methods

A cross-sectional study included patients in monotherapy for at least 36 months with Tafluprost 0.0015% (27) or PF Timolol 0.1% (24) and 20 healthy age and sex-matched volunteers. All subjects underwent clinical tests (Schirmer I and break-up time), in vivo confocal microscopy (IVCM) and were surveyed using Ocular Surface Disease Index (OSDI) and Glaucoma Symptoms Scale (GSS) questionnaires. The groups were compared with ANOVA, Kruskal-Wallis test, t-test, Mann-Whitney test and Bonferroni’s adjustment of p-values.

Results

No significant differences were found in questionnaires scores, clinical tests, IVCM variables between therapy groups. Tafluprost 0.0015% group showed significantly higher OSDI score, basal epithelial cells density, stromal reflectivity, sub-basal nerves tortuosity (p = 0.0000, 0.037, 0.006, 0.0000) and less GSS score, number of sub-basal nerves (p = 0.0000, 0.037) than controls but similar clinical tests results (p > 0.05). PF Timolol group had significantly higher OSDI score, basal epithelial cells density, stromal reflectivity and sub-basal nerve tortuosity (p = 0.000, 0.014, 0.008, 0.002), less GSS score, BUT and number of sub-basal nerves (p = 0.0000, 0.026, 0.003) than controls.

Conclusions

Compared to PF Timolol 0.1%, Tafluprost 0.0015% showed similar safety with regards to tear function and corneal status and a similar tolerability profile. Both therapy groups show some alterations in corneal microstructure but no side effects on tear function except for an increased tear instability in PF Timolol 0.1% group. Ophtalmologists should be aware that even PF formulations may lead to a mild ocular surface impairment.
Literature
1.
go back to reference Leske MC, Heijl A, Hussein M, Bengtsson B, Hyman L, Komaroff E, Early Manifest Glaucoma Trial Group. Factors for glaucoma progression and the effect of treatment : the early manifest glaucoma treatment trial. Arch Ophtalmol. 2003;121:48–56.CrossRef Leske MC, Heijl A, Hussein M, Bengtsson B, Hyman L, Komaroff E, Early Manifest Glaucoma Trial Group. Factors for glaucoma progression and the effect of treatment : the early manifest glaucoma treatment trial. Arch Ophtalmol. 2003;121:48–56.CrossRef
2.
go back to reference McKinnon SJ, Goldberg LD, Peeples P, Walt JG, Bramley TJ. Current management of glaucoma and the need for complete therapy. Am J Manag Care. 2008;14(1 Suppl):S20–7.PubMed McKinnon SJ, Goldberg LD, Peeples P, Walt JG, Bramley TJ. Current management of glaucoma and the need for complete therapy. Am J Manag Care. 2008;14(1 Suppl):S20–7.PubMed
3.
go back to reference Martone G, Frezzotti P, Tosi GM, Traversi C, Mittica V, Malandrini A, et al. An in vivo confocal microscopy analysis of effects of topical antiglaucoma therapy with preservative on corneal innervation and morphology. Am J Ophtalmol. 2009;147(4):725–35.CrossRef Martone G, Frezzotti P, Tosi GM, Traversi C, Mittica V, Malandrini A, et al. An in vivo confocal microscopy analysis of effects of topical antiglaucoma therapy with preservative on corneal innervation and morphology. Am J Ophtalmol. 2009;147(4):725–35.CrossRef
4.
go back to reference Pisella PJ, Poliquen P, Baudouin C. Prevalence of ocular symptoms and signs with preserved and preservative-free glaucoma medication. Br J Ophtalmol. 2002;86:418–23.CrossRef Pisella PJ, Poliquen P, Baudouin C. Prevalence of ocular symptoms and signs with preserved and preservative-free glaucoma medication. Br J Ophtalmol. 2002;86:418–23.CrossRef
5.
go back to reference Garcia-Feijoo J, Sampaolesi JR. A multicenter evaluation of ocular surface disease prevalence in patients with glaucoma. Clin Ophtalmol. 2012;6:441–6. Garcia-Feijoo J, Sampaolesi JR. A multicenter evaluation of ocular surface disease prevalence in patients with glaucoma. Clin Ophtalmol. 2012;6:441–6.
6.
go back to reference Erb C, Gast U, Schremmer D. German register for glaucoma patients with dry eye. I. Basic outcome with respect to dry eye. Graefes Arch Clin Exp Ophtalmol. 2008;246:1593–601.CrossRef Erb C, Gast U, Schremmer D. German register for glaucoma patients with dry eye. I. Basic outcome with respect to dry eye. Graefes Arch Clin Exp Ophtalmol. 2008;246:1593–601.CrossRef
7.
go back to reference Eatsy DL, Nemeth-Wasmer G, Vounatsos JP, Girard B, Besnainou N, Pouliquen P. et al. Comparison of a non-preserved 0.1% T-gel eye gel (single dose unit) with a preserved 0.1% T-gel eye gel (multidose) in ocular hypertension and glaucomatous patients. Br J Ophtalmol. 2006;90:574–8.CrossRef Eatsy DL, Nemeth-Wasmer G, Vounatsos JP, Girard B, Besnainou N, Pouliquen P. et al. Comparison of a non-preserved 0.1% T-gel eye gel (single dose unit) with a preserved 0.1% T-gel eye gel (multidose) in ocular hypertension and glaucomatous patients. Br J Ophtalmol. 2006;90:574–8.CrossRef
8.
go back to reference Uusitalo H, Kaarniranta K, Ropo A. Pharmacokinetics, efficay and safety profiles of preserved and preservative free tafluprost in healthy volunteers. Acta Ophtalmol. 2008;86(S242):7–13.CrossRef Uusitalo H, Kaarniranta K, Ropo A. Pharmacokinetics, efficay and safety profiles of preserved and preservative free tafluprost in healthy volunteers. Acta Ophtalmol. 2008;86(S242):7–13.CrossRef
9.
go back to reference Bean GW, Camras CB. Commercially available prostaglandin analogs for the reduction of intraocular pressure : similarities and differences. Surv Ophtalmol. 2008;53(Suppl 1):S 69–84.CrossRef Bean GW, Camras CB. Commercially available prostaglandin analogs for the reduction of intraocular pressure : similarities and differences. Surv Ophtalmol. 2008;53(Suppl 1):S 69–84.CrossRef
10.
go back to reference Rossi GC, Pasinetti GM, Raimondi M, Ricciardelli G, Scudeller L, Blini M, et al. Efficacy and ocular surface tolerability of preservative-free tafluprost 0.0015%: a 6-month, single-blind, observational study on naïve ocular hypertension or glaucoma patients. Expert Opin Drug Saf. 2012;11(4):519–25.CrossRefPubMed Rossi GC, Pasinetti GM, Raimondi M, Ricciardelli G, Scudeller L, Blini M, et al. Efficacy and ocular surface tolerability of preservative-free tafluprost 0.0015%: a 6-month, single-blind, observational study on naïve ocular hypertension or glaucoma patients. Expert Opin Drug Saf. 2012;11(4):519–25.CrossRefPubMed
11.
go back to reference Janulevičienė I, Derkaa I, Grybauskiene L, Paulauskaitė R, Gromnickaite R, Kuzmienė L. Effects of preservative free tafluprost on tear film osmolarity, tolerability, and intraocular pressure in previously treated patients with open angle glaucoma. Clin Ophtalmol. 2012;6:103–9.CrossRef Janulevičienė I, Derkaa I, Grybauskiene L, Paulauskaitė R, Gromnickaite R, Kuzmienė L. Effects of preservative free tafluprost on tear film osmolarity, tolerability, and intraocular pressure in previously treated patients with open angle glaucoma. Clin Ophtalmol. 2012;6:103–9.CrossRef
12.
go back to reference Uusitalo H, Chen E, Pfeiffer N, Brignole-Baudouin F, Kaarniranta K, Leino M, et al. Switching from a preserved to a preservative-free prostaglandin preparation in topical glaucoma medication. Acta Ophthalmol. 2010;88(3):329–36.CrossRefPubMed Uusitalo H, Chen E, Pfeiffer N, Brignole-Baudouin F, Kaarniranta K, Leino M, et al. Switching from a preserved to a preservative-free prostaglandin preparation in topical glaucoma medication. Acta Ophthalmol. 2010;88(3):329–36.CrossRefPubMed
13.
go back to reference Kuppens EV, De Jong CA, Stolwijk TR, De Keizer RJ, Van Best JA. Effect of timolol with and without preservative on the basal tear turnover in glaucoma. Br J Ophthalmol. 1995;79(4):339–42.CrossRefPubMedPubMedCentral Kuppens EV, De Jong CA, Stolwijk TR, De Keizer RJ, Van Best JA. Effect of timolol with and without preservative on the basal tear turnover in glaucoma. Br J Ophthalmol. 1995;79(4):339–42.CrossRefPubMedPubMedCentral
14.
go back to reference Baudouin C, Hamard P, Liang H, Creuzot-Garcher C, Bensoussan L, Brignole F. Conjunctival epithelial cell expression of interleukins and inflammatory markers in glaucoma patients treated over the long term. Ophtalmology. 2004;111(12):2186–92.CrossRef Baudouin C, Hamard P, Liang H, Creuzot-Garcher C, Bensoussan L, Brignole F. Conjunctival epithelial cell expression of interleukins and inflammatory markers in glaucoma patients treated over the long term. Ophtalmology. 2004;111(12):2186–92.CrossRef
15.
go back to reference Ishibashi T, Yokoi N, Kinoshita S. Comparison of the short term effects on the human corneal surface of topical timolol maleate with and without benzalkonium chloride. J Glaucoma. 2003;12(6):486–90.CrossRefPubMed Ishibashi T, Yokoi N, Kinoshita S. Comparison of the short term effects on the human corneal surface of topical timolol maleate with and without benzalkonium chloride. J Glaucoma. 2003;12(6):486–90.CrossRefPubMed
16.
go back to reference Iester M, Telani S, Frezzotti P, Motolese I, Figus M, Fogagnolo P, et al. Ocular surface changes in glaucomatous patients treated with and without preservatives beta-blockers. J Ocul Pharmacol Ther. 2014;30(6):476–81.CrossRefPubMed Iester M, Telani S, Frezzotti P, Motolese I, Figus M, Fogagnolo P, et al. Ocular surface changes in glaucomatous patients treated with and without preservatives beta-blockers. J Ocul Pharmacol Ther. 2014;30(6):476–81.CrossRefPubMed
17.
go back to reference Frezzotti P, Fogagnolo P, Haka G, Motolese I, Iester M, Bagaglia SA, et al. In vivo confocal microscopy of conjunctiva in preservative-free timolol 0.1% gel formulation therapy for glaucoma. Acta Ophthalmol. 2014;92(2):e133–40.CrossRefPubMed Frezzotti P, Fogagnolo P, Haka G, Motolese I, Iester M, Bagaglia SA, et al. In vivo confocal microscopy of conjunctiva in preservative-free timolol 0.1% gel formulation therapy for glaucoma. Acta Ophthalmol. 2014;92(2):e133–40.CrossRefPubMed
18.
go back to reference Chabi A, Varma R, Tsai JC, Lupinacci R, Pigeon J, Baranak C, et al. Randomized clinical trial of the efficacy and safety of preservative-free tafluprost and timolol in patients with open-angle glaucoma or ocular hypertension. Am J Ophthalmol. 2012;153(6):1187–96.CrossRefPubMed Chabi A, Varma R, Tsai JC, Lupinacci R, Pigeon J, Baranak C, et al. Randomized clinical trial of the efficacy and safety of preservative-free tafluprost and timolol in patients with open-angle glaucoma or ocular hypertension. Am J Ophthalmol. 2012;153(6):1187–96.CrossRefPubMed
19.
go back to reference Lopilly HY, Kim JH, Lee KM, Park CK. Effect of prostaglandin analogues on tear proteomics and expression of cytokines and matrix metalloproteinases in the conjunctiva and cornea. Exp Eye Res. 2012;94(1):13–21.CrossRef Lopilly HY, Kim JH, Lee KM, Park CK. Effect of prostaglandin analogues on tear proteomics and expression of cytokines and matrix metalloproteinases in the conjunctiva and cornea. Exp Eye Res. 2012;94(1):13–21.CrossRef
20.
go back to reference Fogagnolo P, Dipinto A, Vanzulli E, Maggiolo E, De Cilla’ S, Autelitano A, et al. A 1-year randomized study of the clinical and confocal effects of tafluprost and latanoprost in newly diagnosed glaucoma patients. Adv Ther. 2015;32(4):356–69.CrossRefPubMedPubMedCentral Fogagnolo P, Dipinto A, Vanzulli E, Maggiolo E, De Cilla’ S, Autelitano A, et al. A 1-year randomized study of the clinical and confocal effects of tafluprost and latanoprost in newly diagnosed glaucoma patients. Adv Ther. 2015;32(4):356–69.CrossRefPubMedPubMedCentral
21.
go back to reference Bergonzi C, Giani A, Blini M, Marchi S, Luccarelli S, Staurenghi G. Evaluation of prostaglandin analogue effects on corneal keratocyte density using scanning laser confocal microscopy. J Glaucoma. 2010;19:617–21.CrossRefPubMed Bergonzi C, Giani A, Blini M, Marchi S, Luccarelli S, Staurenghi G. Evaluation of prostaglandin analogue effects on corneal keratocyte density using scanning laser confocal microscopy. J Glaucoma. 2010;19:617–21.CrossRefPubMed
22.
go back to reference Rossi GC, Blini M, Scudeller L, Ricciardelli G, Depolo L, Amisano A, et al. Effect of preservative-free tafluprost on keratocytes, sub-basal nerves, and endothelium: a single-blind one-year confocal study on naïve or treated glaucoma and hypertensive patients versus a control group. J Ocul Pharmacol Ther. 2013;29(9):821–5.CrossRefPubMed Rossi GC, Blini M, Scudeller L, Ricciardelli G, Depolo L, Amisano A, et al. Effect of preservative-free tafluprost on keratocytes, sub-basal nerves, and endothelium: a single-blind one-year confocal study on naïve or treated glaucoma and hypertensive patients versus a control group. J Ocul Pharmacol Ther. 2013;29(9):821–5.CrossRefPubMed
23.
go back to reference Mastropasqua L, Agnifili L, Fasanella V, Curcio C, Ciabattoni C, Mastropasqua R, et al. Conjunctival goblet cells density and preservative-free tafluprost therapy for glaucoma: an in vivo confocal microscopy and impression cytology study. Acta Ophthalmol. 2013;91(5):e397–405.CrossRefPubMed Mastropasqua L, Agnifili L, Fasanella V, Curcio C, Ciabattoni C, Mastropasqua R, et al. Conjunctival goblet cells density and preservative-free tafluprost therapy for glaucoma: an in vivo confocal microscopy and impression cytology study. Acta Ophthalmol. 2013;91(5):e397–405.CrossRefPubMed
24.
go back to reference Ranno S, Fogagnolo P, Rossetti L, Orzalesi N, Nucci P. Changes in corneal parameters at confocal microscopy in treated glaucoma patients. Clin Ophthalmol. 2011;5:1037–42.CrossRefPubMedPubMedCentral Ranno S, Fogagnolo P, Rossetti L, Orzalesi N, Nucci P. Changes in corneal parameters at confocal microscopy in treated glaucoma patients. Clin Ophthalmol. 2011;5:1037–42.CrossRefPubMedPubMedCentral
25.
go back to reference European Glaucoma Society terminology and guidelines for glaucoma, 4th Edition. European Glaucoma Society terminology and guidelines for glaucoma, 4th Edition.
Metadata
Title
Long term safety and tolerability of Tafluprost 0.0015% vs Timolol 0.1% preservative-free in ocular hypertensive and in primary open-angle glaucoma patients: a cross sectional study
Authors
Teresa Rolle
Roberta Spinetta
Raffaele Nuzzi
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2017
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-017-0534-z

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