The intraocular pressure reducing effect of brinzolamide as adjunctive therapy to latanoprost.

To determine the intraocular pressure (IOP) lowering effect of brinzolamide when added to latanoprost. Patients who were simultaneously on brinzolamide and latanoprost were identified from the large prospective database of patients diagnosed with primary open angle glaucoma, normal tension glaucoma or ocular hypertension maintained in our glaucoma clinic. Only patients who had been on latanoprost for at least six weeks before introduction of brinzolamide were included. Their case notes were reviewed to determine the intraocular pressure at baseline, after addition of brinzolamide and prior to subsequent treatment change if any. Ninety-three patients were identified. Data for seventy-two patients were analysed. Average age was 70 with a male to female ratio of 4:5. The mean baseline IOP was 20.8 ± 4.6 mmHg with 47 diagnosed with primary open angle glaucoma, 16 with normal tension glaucoma and 9 with ocular hypertension. The reduction in IOP was 4.1 ± 0.9 mmHg (95% confidence limits, p < 0.001) at 4.0 months median follow up. This corresponds to 19.8% reduction of IOP from baseline. A 12.5% proportion of patients did not have a reduction in IOP, 3.2% and 2.1% reported ocular irritation and blurring of vision respectively. At last mean follow up of 45 months, 51% of patients remained on this treatment. In the majority of patients, brinzolamide reduced IOP by a further 19.8% in patients already on latanoprost monotherapy. This effect was maintained in 51% of patients after 42 months.