Effects of latanoprost and dipivefrin, alone or combined, on intraocular pressure and on blood-aqueous barrier permeability.

To investigate the effect on intraocular pressure (IOP) and aqueous flare of topical applications of latanoprost and dipivefrin alone or combined. 22 patients with open angle glaucoma or ocular hypertension were included in a 4 week open label study. Median age was 68 years (range 50-79). They were allocated to either 2 weeks' treatment with once daily evening administration of latanoprost monotherapy (50 micrograms/ml) or twice daily dipivefrin monotherapy (1 mg/ml), followed by 2 weeks' combination therapy with both drugs. Latanoprost alone reduced IOP from 19.3 (SD 1.4) to 14.8 (0.9) mm Hg (p < 0.01). Addition of dipivefrin caused a further reduction to 12.4 (0.9) mm Hg (p < 0.01 compared with latanoprost alone). In the group where the treatment started with dipivefrin IOP was reduced from 22.3 (1.2) to 18.4 (1.0) mm Hg (p < 0.01) and with the combination to 14.9 (0.9) mm Hg (p < 0.01). No change in aqueous flare was observed with either drug, alone or in combination. A slight increase in conjunctival hyperaemia was observed when the two drugs were combined. Latanoprost and dipivefrin have an additive effect on IOP and no clinically significant effect on the permeability to proteins of the blood-aqueous barrier. This implies that the two drugs can be a useful combination for the treatment of glaucoma.