Nyctohemeral effects of topical beta-adrenoceptor blocking agents measured with an intraocular telemetry sensor

Objective: To evaluate nyctohemeral effects of topical beta-adrenoceptor blocking agents and their fixed combinations on intraocular pressure (IOP) in patients with primary open-angle glaucoma implanted with an ocular telemetry sensor.

Methods: 22 patients who had previously been implanted with a sulcus-based IOP sensor (eyemate) were included in this prospective clinical trial. Three classes of medications were analysed: beta-blockers (BB), fixed combination of BB and carbonic anhydrase inhibitors (BB-CAI), and combinations of BB and prostaglandin analogues (BB-PGAs). SD and IQR of IOP were calculated and used as surrogates of nyctohemeral IOP variation.

Results: The mean (±SD) age of patients was 67.8±6.8 years (36.4% female). A total of 50 920 IOP measurements over 4084 days from 10 eyes were included. The mean 24-hour IOP (±SE) with BB-PGA (17.3±1.1 mm Hg) was significantly (p<0.001) less than that with BB (18.8±1.1 mm Hg). Mean 24-hour IOP with BB-CAI (18.4±1.1 mm Hg) was similar (p>0.05) to that with the other two medications. Mean 24-hour SD of IOP with BB-PGA (1.9±0 .2 mm Hg) and BB-CAI (2.0±0.2 mm Hg) were significantly (p<0.05) less than that with BB (2.4±0.2 mm Hg). Mean 24-hour IQR of IOP with BB-PGA (2.3±0.4 mm Hg) was significantly less than that with both BB (3.8±0.4 mm Hg) and BB-CAI (3.2±0.4 mm Hg).

Conclusion: Continual IOP monitoring shows that combinations of BB-PGAs have more pronounced effects on lowering 24-hour IOP fluctuations than BB-CAIs and BBs alone.

Trial registration number: NCT03651336.