Effect of five years of treatment with nipradilol eye drops in patients with normal tension glaucoma

BACKGROUND The purpose of this study was to evaluate the effects of topical nipradilol monotherapy for 5 years on intraocular pressure, visual field performance, and optic disk topography. METHODS Thirty patients with normal tension glaucoma were monitored for intraocular pressure every 1-3 months. A Humphrey visual field test and measurement of optic disk configuration using the Heidelberg retina tomograph II was done after every year of treatment and the results compared with those before treatment. Visual field performance was also evaluated by trend and event analysis. RESULTS The mean intraocular pressure ± standard deviation after 3 years of nipradilol treatment (14.1 ± 2.0 mmHg) and after 5 years of nipradilol treatment (13.7 ± 2.1 mmHg) was significantly lower than that before treatment (17.0 ± 1.8 mmHg, P < 0.0001). Heidelberg retina tomograph II parameters, such as mean cup depth and height variation contour after treatment, were significantly increased compared with those before treatment. Visual field performance worsened in eight eyes by trend analysis and eight eyes by event analysis. CONCLUSION Nipradilol monotherapy was effective in reducing intraocular pressure over at least 5 years without worsening of optic disk topography. Furthermore, mean cup depth and height variation contour were also significantly improved. However, visual field performance worsened in 16.0% of patients with normal tension glaucoma.