Key result
Topical timolol reduces resting heart rate by ~3 beats/minute after 4 weeks of therapy.
Why the study?
Topical beta-blockers like Timolol may cause cardiopulmonary side effects in elderly patients with primary open angle glaucoma, but quantitative evaluation of these effects is limited.
RCT (n=40)
randomly divided into four groups
No
Mean Difference: -3.2
Absolute Event Rate: 70.6% vs 73.8%
p-value: p=0.0005
Purpose: To quantitatively evaluate the cardiopulmonary effects of various topical antiglaucoma drugs. Material & method:In this study, forty consecutive cases of newly diagnosed primary open angle glaucoma were recruited.After taking a detailed history, an ophthalmological examination and a systemic examination including resting pulse rate, blood pressure, ECG, auscultation of the chest and spirometry were performed.Then the patients were randomly divided into four groups and one of the four topical anti glaucoma medication (Timolol, Latanoprost, Brimonidine, and Dorzolamide) prescribed.Patients were reviewed 4 weeks later and the same ocular and systemic examinations were performed.Result: Timolol therapy reduced all the spirometry parameters that are statistically significant difference with the P value of less than 0.1.Timolol therapy resulted in the mean reduction of pulse rate by 3.2 beats/ minute and a mean reduction of systolic and diastolic blood pressure by 5.8 mmHg and 5.6 mmHg, respectively all the spirometry & cardiovascular parameters remained unchanged in the other three groups after 4 weeks of treatment.Conclusion: Timolol significantly affects the cardiopulmonary status.Therefore, we could advice the assessment of cardiopulmonary status mandatory in patients receiving topical beta-blockers.Bronchospasm may be of clinical significance in the elderly, who commonly have undiagnosed reversible airway obstruction.
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Litoriya et al. (2019) conducted an RCT in Primary open angle glaucoma (POAG) (n=40). Timolol vs. Latanoprost, Brimonidine, Dorzolamide was evaluated on Heart rate (beats/minute) at 4 weeks (MD -3.2, p=0.0005). Topical timolol significantly reduced resting heart rate by a mean of 3.2 beats/minute (p=0.0005) and decreased peak expiratory flow rate after 4 weeks of therapy compared to baseline, whereas other treatments showed no such effects.
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