The use of dorzolamide versus other hypotensive agents to prevent glaucomatous progression

PURPOSE To evaluate progression rates with dorzolamide compared with other hypotensive agents in primary open-angle glaucoma. METHODS Patients who were treated over 5 years with dorzolamide versus other hypotensive agents were reviewed. The groups were matched by intraocular pressure, cardiovascular history, and age. RESULTS In 50 matched pairs, 2 (4%) of dorzolamide and 7 (14%) of control patients suffered glaucomatous progression (p = 0.09). Progressed dorzolamide patients had pressures of 13 versus 15-20 mmHg in the control group. Control patients progressed after 26.4 months and dorzolamide patients after 38.9 months. CONCLUSIONS Although the results were not statistically significant, this pilot trial demonstrated a trend towards less glaucomatous progression in patients treated with an assumed active blood flow product. In addition, progression was delayed and occurred at lower pressures in the active blood flow group. This pilot trial suggests that future prospective, long-term, clinical outcomes studies in patients treated with a medicine with a positive ocular blood flow effect may be warranted.