The Circadian Changes of Intraocular Pressure and Ocular Perfusion Pressure After Tafluprost Compared with Travoprost in Normal Tension Glaucoma

Purpose: To compare the 24-h changes of intraocular pressure (IOP) and mean ocular perfusion pressure (MOPP) obtained with tafluprost versus travoprost in patients with normal-tension glaucoma (NTG). Methods: This study is a randomized crossover study of 50 patients newly diagnosed with NTG who received either tafluprost or travoprost given once at 9 PM for 2 months, after which they were crossed over to the other medication for another 2 months. IOP and blood pressure were measured for 24 h before starting the treatment and after finishing the first and second treatment periods. Results: Forty-one patients completed the study. The mean (+/- standard deviation) 24-h IOP was 16.8 +/- 2.0 mmHg at baseline, 14.4 +/- 2.2 mmHg on tafluprost, and 13.6 +/- 1.8 mmHg on travoprost. Both prostaglandin monotherapies significantly reduced mean 24-h IOP as compared with baseline (P<0.001, P<0.001, respectively), and travoprost demonstrated a lower mean 24-h IOP than tafluprost (P=0.044). Both treatments significantly reduced the IOP from baseline at every point over 24 h. At 3 individual time points, travoprost provided a lower IOP than tafluprost: at 4 PM (13.8 +/- 2.7 vs. 14.8 +/- 2.6 mmHg, P=0.041), at 6 PM (13.5 +/- 2.5 vs. 14.4 +/- 2.5 mmHg, P=0.006), and at 8 PM (13.3 +/- 2.5 vs. 14.5 +/- 2.4 mmHg, P=0.029). Both tafluprost and travoprost significantly increased the 24-h MOPP (P=0.008, P=0.002, respectively), and travoprost demonstrated a greater 24-h MOPP than tafluprost (P=0.027). Conclusions: Both tafluprost and travoprost were effective in lowering IOP and increasing MOPP throughout 24 h in NTG. However, travoprost reduced IOP greater than tafluprost in the late afternoon and evening.