Brimonidine vs ALTP in Progressing Human Glaucoma

Condition(s) targeted: Glaucoma

Intervention: brimonidine (Drug); laser trabeculoplasty (Procedure)

Phase: Phase 4

Status: Completed

Sponsored by: University of Parma

Official(s) and/or principal investigator(s):
stefano gandolfi, MD, Principal Investigator, Affiliation: University of Parma

This study is evaluating possible non-intraocular pressure (IOP) related effects of the alpha-1 agonist brimonidine in human subjects affected by a progressive glaucomatous optic neuropathy. Brimonidine was proven as neuroprotective in several pre-clinical animal studies.

Official title: Topical Brimonidine vs Argon Laser Trabeculoplasty in Progressing Human Glaucoma. A Prospective Randomized Clinical Trial.

Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind, Primary Purpose: Treatment

Primary outcome:

progression of visual field measured as loss of sensitivity in decibels per year

progression of visual field measured as number of eyes showing at least one cluster of points progressing

Secondary outcome: number of drop out(s) for adverse events

Detailed description: Patients with open angle glaucoma and a history of relative stability of the visual field are followed for 18 months. A visual field is measured every 3 months for a total number of n = 6 eligible fields at the end of this phase. Then, those eyes showing progression of the field (i. e. deterioration of th eexisting glaucoma), are randomized to receive either 0. 2% brimonidine tartrate eyedrops b. i.d. or 360° argon laser trabeculoplasty in one session. Either treatment will be put "on top" of the pre-existing anti-glaucoma therapy. Then, a further 18-month phase is planned, with a sequnece of field taken at the same pace as the previous phase. Progression is detected (and measured) acording to a trend-analysis (i. e. regression vs time of single points and of clusters of adjacent points).

Minimum age: 50 Years. Maximum age: 70 Years. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Glaucomatous visual field defect on achromatic perimetry (24/2 Humphrey full

threshold,abnormal GHT and CPSD, p<0. 01) considered clinically “unstable”

- IOP < 20 mmHg on repeated readings with no more than 2 medications,

- Open angle on gonioscopy,

- Glaucomatous optic neuropathy (HRTII, Moorfields regression analysis),

- Clear lens (LOCS2 score < C1, N0, P0)

- Best corrected visual acuity better than 0. 2 LogMAR (ETDRS chart),

- No previous bulbar surgery

- Manifest refraction within – 5 and + 2 diopters

- No comorbidity (AMD and diabetic retinopathy. and negative history for neurological

diseases) Exclusion Criteria:

- Closed angle

- Previous bulbar surgery

- Unstable IOP

- Unreliable visual fields on historic data

sezione di Oftalmologia, Parma 43100, Italy

Starting date: August 1999
Last updated: April 26, 2007