J Korean Ophthalmol Soc.  2018 May;59(5):451-458. 10.3341/jkos.2018.59.5.451.

Comparison of Allergy Prevalence between Brimonidine/Timolol Fixed Combination and 0.15% Brimonidine in Glaucoma Patients

• Park EJ
• Chun YS

• KMID: 2411453
• DOI: http://doi.org/10.3341/jkos.2018.59.5.451

Abstract

PURPOSE
To compare the allergy prevalence and clinical manifestations of 0.2% brimonidine/0.5% timolol fixed combination (BTFC) and 0.15% brimonidine in Korean patients with glaucoma.
METHODS
We retrospectively analyzed the medical records of 196 glaucoma patients treated with BTFC and 234 glaucoma patients treated with 0.15% brimonidine. We compared sex, age, type of glaucoma, treatment period, allergy history, onset time of ocular allergy and clinical characteristics of allergy in the two groups.
RESULTS
Ocular allergy percentages 10.14% in the BTFC group and 22.02% in the 0.15% brimonidine group, and the risk of allergy was approximately 0.4 times lower in patients using BTFC (hazard ratio = 2.5, p = 0.009). The BTFC group developed ocular allergy at a mean of 20.5 months (range: 1.7-51.1 months), and the 0.15% brimonidine group developed ocular allergy at a mean of 7.7 months (range: 0.4-50.8 months). In the BTFC group, 50% of the ocular allergy occurred within 15 months, and within 5 months in the 0.15% brimonidine group. Clinical characteristics of brimonidine allergy involved two types of conjunctival follicles and conjunctival papillae, but there were no significant differences in incidence according to allergy type (p = 0.566).
CONCLUSIONS
The prevalence of ocular allergy in the BTFC group was lower than that in the 0.15% brimonidine group in Korean patients with glaucoma. The results of this study are expected to be useful for patient education and compliance improvement using brimonidine.

Keyword

Glaucoma; Korean; Ocular allergy; 0.2% brimonidine/0.5% timolol fixed combination; 0.15% brimonidine

MeSH Terms

Brimonidine Tartrate*
Compliance
Glaucoma*
Humans
Hypersensitivity*
Incidence
Medical Records
Patient Education as Topic
Prevalence*
Retrospective Studies
Timolol
Brimonidine Tartrate
Timolol

Figure

• 

  Figure 1. Summarized flow chart of patients. Among 430 glaucoma patients who treated with brimonidine 0.2%/timolol 0.5% fixed combination (BTFC) or 0.15% brimonidine, a total 257 patients were enrolled after application of exclusion criteria.

• 

  Figure 2. Percentage of patients who developed an ocular allergy to 0.2% brimonidine/0.5% timolol fixed combination (BTFC) and 0.15% brimonidine. In the BTFC group, 50% of the ocular allergy occurred within 15 months, and within 5 months in the 0.15% brimonidine group. Compared with 0.15% brimonidine group, only 20% of the ocular allergy occurred in the BTFC group within the first 5 months of treatment.

• 

  Figure 3. Kaplan– Meier curve, showing distribution of time to withdrawal due to allergic reaction for 0.2% brimoni-dine/0.5% timolol fixed combination (BTFC) versus 0.15% brimonidine. During the entire course of the observation period, the proportion of patients who discontinued treatment due to ocular allergy was lower in the BTFC group than in the 0.15% brimonidine group.

• 

  Figure 4. Slit-lamp photographs of the ocular allergy on left eye in patient who used 0.2% brimonidine/0.5% timolol fixed combination just in her left eye. (A, B) Right eye showed clear cornea and conjunctive. (C, D) Left eye showed significant hyperemia and distinguishing giant follicles on the upper and lower palpebral conjunctivae.

Reference

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