Effect of systemic antihypertensives on change in intraocular pressure after initiating topical prostaglandins for primary open-angle glaucoma

Abstract

Mehdi Siddiqui,1,* Joshua Iltis,1,* Petar Yanev,1 John Sladic,1 Charles Huynh,1 Daniel Nolan,2 Michael Singer2 1Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA; 2Medical Center Ophthalmology Associates, San Antonio, TX, USA *These authors contributed equally to this work Purpose: There is a limited understanding of factors that influence the efficacy of topical glaucoma medication. Our study is a long-term, case–control analysis of how systemic antihypertensive (anti-HTN) medications influence the change in IOP after initiating prostaglandin (PG) drop therapy.Materials and methods: A retrospective chart review of 3,781 patients was performed on patients with a diagnosis of glaucoma suspect that progressed to primary open-angle glaucoma (POAG) by ICD-9 codes over a 10-year period. Inclusion criteria consisted of the following: 1) progression from preglaucoma to glaucoma diagnosis in a time span of ≥6 months; 2) two visual fields recorded between these dates; 3) initial average IOP of both eyes of ≥21 mmHg; and 4) initiation of topical PG therapy alone. IOP (in mmHg) was measured at initiation of PG drops and at next visit.Results: One hundred eleven patients were qualified for analysis. Patients not on anti-HTN agents had an average IOP decrease of 6.38±0.56 mmHg. Comparatively, patients on anti-HTN agents had an average IOP decrease of 6.66±0.48 mmHg (P=0.61). In addition, there was no statistical difference between IOP decrease between patients on single vs multiple systemic anti-HTN agents (P=0.85). There were eight nonresponders to PGs on no anti-HTN medications and 12 nonresponders on anti-HTN medication (P=0.55).Conclusion: Systemic anti-HTN medication use did not significantly impact IOP reduction after topical PG initiation for POAG. Additionally, nonresponse to PG therapy was not correlated to systemic anti-HTN use. Keywords: glaucoma, topical prostaglandins, IOP, systemic antihypertensives, ocular hypertension, prostaglandin eye drop