The diurnal and nocturnal effects of travoprost in normal-tension glaucoma

PURPOSE To determine the diurnal and nocturnal effects of travoprost with sofZia(®) (Travatan Z(®) [TZ]) on intraocular pressure (IOP) and ocular perfusion pressure (OPP) in patients with normal-tension glaucoma (NTG). METHODS Twenty-seven subjects with NTG were admitted to an inpatient sleep laboratory for three 24-hour sessions monitoring IOP, blood pressure (BP), and heart rate every 2 hours in the habitual position (diurnal period: upright; nocturnal period: supine). Baseline IOP and OPP levels were compared to those during active treatment with TZ and 3 days after stopping the medication. OPP was calculated as 2/3 [diastolic BP + 1/3 (systolic BP - diastolic BP)] - IOP. RESULTS TZ significantly reduced the mean diurnal and nocturnal IOP levels compared to baseline at all time points. During treatment, mean IOP decreased from 17.1±3.4 to 14.7±3.0 mmHg during the diurnal period (P<0.01) and from 19.9±3.6 to 18.8±3.5 mmHg during the nocturnal period (P<0.01). Once treatment was discontinued, mean IOP remained at levels significantly less than baseline during both the diurnal (15.6±3.2 mmHg) and nocturnal (18.7±3.7 mmHg) periods. Mean OPP was not significantly changed with treatment during either period. CONCLUSION In this population of NTG patients, TZ significantly lowers IOP at all time points throughout the diurnal and nocturnal periods. The treatment effect on IOP endures for up to 3 days after the last dose. Treatment did not significantly improve OPP.