Topical Treatment of Elevated Intraocular Pressure in Patients with Graves' Orbitopathy

Int J Environ Res Public Health. 2020 Dec 13;17(24):9331. doi: 10.3390/ijerph17249331.

Abstract

Purpose: In this study, we evaluated the efficacy of topical hypotensive treatment and/or systemic corticosteroids therapy in patients with elevated intraocular pressure and Graves' orbitopathy (GO). Methods: We included 172 eyes in 86 individuals with duration of GO ≥ 3 months, intraocular pressure in either eye ≥ 25.0 mmHg, and GO ranked ≥ 3 at least in one eye in modified CAS form. The study subjects were divided into three treatment subgroups: subgroup I was administered latanoprost once a day; subgroup II was administered a combined preparation of brimonidine and timolol BID; subgroup III was the control group, not receiving any topical hypotensive treatment. All the study participants received systemic treatment, intravenous corticosteroid therapy at the same dose, according to the European Group of Graves' Orbitopathy (EUGOGO) guideline. Results: On the final visit, the mean IOP value was significantly lower in all treatment subgroups compared to the initial values. In both subgroups receiving topical treatment, the IOP reduction was higher than in the control group receiving systemic corticosteroids only. However, the latanoprost eye drops decreased intraocular pressure more effectively than drops containing brimonidine and timolol. Conclusion: Topical ocular hypotensive treatment is effective in reducing intraocular pressure in GO and decreases intraocular pressure more effectively than systemic corticosteroid therapy alone.

Keywords: Graves’ orbitopathy; exophthalmos; intraocular pressure; topical medications.

MeSH terms

  • Administration, Topical*
  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use
  • Brimonidine Tartrate* / administration & dosage
  • Brimonidine Tartrate* / pharmacology
  • Female
  • Graves Ophthalmopathy* / drug therapy
  • Humans
  • Intraocular Pressure / drug effects
  • Latanoprost* / administration & dosage
  • Latanoprost* / pharmacology
  • Male
  • Timolol* / administration & dosage
  • Timolol* / pharmacology
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Brimonidine Tartrate
  • Latanoprost
  • Timolol