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At least 685 records · Page 38Linked to original sources

PubMed1985

[Timolol and functional perimetric prognosis of primary open-angle glaucoma].

Sixty patients with open angle chronic glaucoma (O.A.C.G.)(31 men, 29 women), 102 eyes, have been treated and followed two or three times a year for a period of three to eight years in Hôpital Saint-Joseph - Paris. Patients have been divided into two groups: group A: 58 eyes treated for at least three years by timolol associated or not with an other treatment: medical, surgical or physical (laser); group B: 44 eyes divided into two sub-groups: group B1: 44 eyes, all having for at least three years a therapy for glaucoma (medical or surgical), other than timolol; group B2: 44 eyes, same population as in group B1 but where timolol as been introduced in the therapy. Perimetric follow-up was performed for all patients by the Friedmann analyser with a calculation for each eye of the total visual capability (TVC). For each eye, a linear relation according to time TVC/IOP has been established so that we could make a comparison of the evolution gradient of visual capabilities with time. It is a retrospective study. It showed that introduction of timolol in the therapy straightened the evolutive slope (severity gradient) of the Friedmann visual capabilities. But, this favorable action is only transient and only lasted three years on the average. In any event, whatever therapy is envisaged, even with rigourous follow-up, the visual field loss progresses inexorably with in the glaucomatous diseases.

Aged↗

PubMed1985

[Evaluation of the systemic effects of timolol maleate in eye drops].

The systemic effects of timolol eye drops were investigated in 35 patients divided into three groups: 1. (15 asthmatics); 2. (10 non-asthmatic patients suffering from glaucoma); 3. (10 elderly control subjects). A placebo eye drops was given at time 0, the timolol maleate drops were given at time 30 mn. The control parameters were checked every 15 minutes. They did not show variations under placebo. After administration of timolol, systolic and diastolic blood pressures as well as vital capacity remained unchanged. Heart rate decreased in 91% of subjects by a mean: 18.5% and, extreme 38%: Bradycardia was always sino-atrial and there was a dose effect relationship. Also F.E.V., decreased in 13 of the 15 asthmatics and in 2 patients with chronic bronchitis: in 4 patients the decrease in flow exceeded 20%. The importance of timolol in the treatment of open-angle chronic glaucoma is well-established, but the results reported here and else where emphazing frequent risks should induce prescribers to comply with the rules of good use: analysis of previous history, and compliance with general contra-indications to beta blockers. Routine E.C.G. and strict adjustment of dosage is recommended.

Asthma↗

PubMed1983

Effect of timolol eye drops in subjects receiving systemic propranolol therapy.

In a double-blind controlled study seven healthy subjects with normal eyes were given alternatively a placebo or 80 or 160 mg of propranolol per day, with an interval of at least 1 week between the three experiments. Two hours after a dose of the medication was taken, two drops of 0.5% timolol maleate were instilled into one eye, and for the next 4 hours the intraocular pressure, pulse rate and blood pressure were measured hourly. Timolol reduced the intraocular pressure substantially and to the same extent in the subjects who had taken a placebo and those who had taken 80 mg of propranolol per day; however, it had almost no effect in those who had taken 160 mg of propranolol per day. There was marked interindividual variation in the response to timolol. No change in the pulse rate or the blood pressure was noted. A similar study was carried out with 12 patients taking propranolol for various cardiovascular problems; their dosage of this agent was not varied, however. The results were basically the same, except that the patients taking 120 mg of propranolol per day had an intermediate response to timolol.

Adult↗

PubMed1984

The effect of Timolol Maleate on tonic accommodation, tonic vergence, and pupil diameter.

The beta-adrenoceptor antagonist Timolol Maleate (0.5%) was employed topically to determine whether the resting (or "tonic") position of accommodation is a consequence of steady-state equilibrium between parasympathetic and sympathetic innervation of the ciliary muscle. Ten subjects were used, eight men and two women, with an age range of 19-37 (mean = 23.2). All subjects wore an optimum refractive correction giving visual acuities of 20/20 or better. Darkroom measurements of tonic accommodation (TA), tonic vergence (TV), and pupil diameter were determined with a Badal laser optometer , a nonius alignment device and infra-red photography, respectively. Far and near points of accommodation and oculo-motor balance tests were determined by standard optometric techniques and intraocular pressure (IOP) was measured by applanation tonometry. Both TA (mean = 1.66 D) and TV (mean = 2.10 deg) assumed intermediate resting positions in the absence of visual stimulation. A double-blind protocol between Timolol and Saline demonstrated a mean myopic shift in TA of +0.85 D over 40 min with Timolol. All other experimental parameters, apart from IOP, were unaffected by Timolol. It is concluded that sympathetic innervation to the ciliary muscle plays a significant role in determining the TA position and that this innervation is mediated by inhibitory beta adrenoceptors.

Accommodation, Ocular↗

PubMed1983

Effects of pilocarpine, salbutamol, and timolol on aqueous humor formation in cynomolgus monkeys.

The rate of aqueous humor formation was determined in the cynomolgus monkey eyes by a tracer dilution technique. One 25-gauge needle was inserted into the posterior chamber and a solution of fluorescein labeled dextran with a molecular weight of 40,000 was infused at a constant rate. The aqueous humor was collected through a needle inserted into the anterior chamber, while the intraocular pressure (IOP) was maintained at a constant level. The aqueous humor formation rate and the dye distribution volume were calculated from the time profile of the dye concentration in the effluent aqueous humor. By means of this technique, the effects of pilocarpine, salbutamol, and timolol on the aqueous humor formation rate were studied. The test drug solution was administered into the conjunctival reservoir during a 90-min period before measurements and also during the measurement so that a steady-state drug concentration was maintained in the anterior chamber during the measurement. Pilocarpine 0.1% reduced the aqueous humor formation rate to approximately 50% of the control without significantly changing the IOP or the distribution volume. Salbutamol 0.5%, a beta-adrenergic agonist, increased the rate by about 38%, but timolol 0.1%, a beta-adrenergic antagonist, reduced the rate by an average of 36%. Timolol caused a statistically significant lowering of the IOP by about 2 mmHg. Simultaneous administration of salbutamol 0.5% and timolol 0.2% caused no change in the aqueous humor formation rate or the IOP. The barrier function of the blood aqueous barrier was not altered by these drugs as revealed by aqueous protein determinations.

Albuterol↗

PubMed1982

A comparative trial of timolol and flutonidin as antihypertensive agents.

In a double-blind cross-over clinical trial, flutonidin (2-4 mg daily) was compared with timolol (20-40 mg daily) in the treatment of mildly or moderately hypertensive patients who concomitantly received fixed diuretic treatment. Each drug was administered for 1 month, with an interval of 2 weeks between the two monthly periods. During administration of flutonidin, blood pressure initially fell but returned to baseline values at the end of treatment. Heart rate was not affected by the drug. Timolol significantly reduced both blood pressure and heart rate. Its effect becomes evident during the 1st week and increases throughout the treatment period. Side effects were more frequent during flutonidin administration than during timolol administration. No significant modifications of the laboratory findings were observed during either flutonidin or timolol treatment.

Adult↗

PubMed1981

Bradycardia and congestive heart failure associated with ocular timolol maleate.

A case of timolol-associated heart failure in a 73-year old white man is reported. The patient, with a history of cardiovascular disease and glaucoma, was admitted to the hospital because of complaints of shortness of breath, orthopnea, and reduced exercise tolerance. Chest roentgenogram showed interstitial congestive failure, and an EKG demonstrated sinus bradycardia. The patient's medications before admission included quinidine, isosorbide dinitrate, dipyridamole, aspirin, pilocarpine eyedrops 4%, timolol eyedrops 0.5%, and nitroglycerin ointment and sublingual tablets. On the second day of hospitalization, it was noted that the patient's dyspnea and sinus bradycardia could be related to a recent increase in his timolol dosage. The timolol was discontinued, and the patient's heart rate increased. As the patient's pulse rate increased, the symptoms of congestive heart failure disappeared. This case demonstrated the importance of obtaining complete drug histories from patients. The potential for adverse system reactions resulting from topical medications should be considered.

Aged↗

PubMed1981

Effect of timolol maleate on intraocular pressure and pupil cycle time in normal eyes.

One drop of 0.5% timolol maleate instilled into the normal eyes of four subjects produced a marked reduction of intraocular pressure that was maximal at 3 hours but not significant after 12 hours. Instillation of one drop a day for 30 days produced a reliable, maintained reduction of intraocular pressure in the treated eye. The pupil cycle time in both eyes was measured at least twice daily for 1 week before timolol treatment to assess the reproducibility of the test and then twice daily for the 30 days of treatment with timolol. The drug had no significant effect on the pupil cycle time. Measuring the pupil cycle time should afford the ophthalmologist a useful method of assessing the progress of glaucomatous damage to the optic nerve while the patient is undergoing treatment with timolol, an assessment that was not possible when patients were treated with pilocarpine.

Administration, Topical↗

PubMed1996

Ocular tolerability of timolol in Gelrite in young glaucoma patients.

BACKGROUND: Although initial patient response to timolol maleate in Gelrite (Timoptic XE) has been generally favorable in clinical settings, anecdotal reports of blurred vision warrant further investigation comparing the tolerability of this new formulation with that of timolol maleate in conventional solution. METHODS: A prospective, double-masked, randomized, cross-over study was performed using 28 normal volunteers who had no evidence of ocular disease, including glaucoma. Mean subject age was 32.5 years. Subjects were randomized to receive one drop in each eye of either timolol maleate in solution (TS) 0.5 percent or timolol maleate in Gelrite (TXE) 0.5 percent. Subjects rated each medication, using a visual analog scale, at the following time intervals: prior to drug instillation, immediately following instillation, 1 min, and at 15 min, 30 min, 1 hour, 2 hours, and 4 hours. RESULTS: Wilcoxon Matched Paris Test showed statistically significant differences at 1 minute for tearing (p = 0.003), blurred vision (p = 0.001) and drug acceptance (p = 0.028) in favor of TS. At 15 minutes and thereafter, however, none of the differences between groups was significant. Visual acuities were unaffected by either TS or TXE. CONCLUSIONS: These data suggest that TXE may impair visual function more than TS, but these effects are briefly and transitory. TXE appears to be a clinically acceptable drug delivery vehicle for use during the young glaucoma patient's waking hours.

Adrenergic beta-Antagonists↗

PubMed1997

Enhanced acute ocular hypotensive response to timolol with dexamethasone treatment.

PURPOSE: This study was conducted to determine whether low doses of dexamethasone can enhance the lowering of ocular pressure by low doses of timolol. PATIENTS AND METHODS: In 12 patients with untreated ocular hypertension and similar intraocular pressures in each eye, one eye was randomly selected in a masked manner for pretreatment with three applications of topical 0.01% dexamethasone sodium phosphate drops prepared in artificial tears. The other eye was treated with three applications of drops of artificial tears alone. Both eyes were then treated with 0.01% timolol maleate drops. Ocular pressure was measured for the next 100 minutes at 20-minute intervals. The study was done in an outpatient office. Twelve untreated ocular hypertensive patients participated in this study. RESULTS: When compared with eyes treated with timolol drops alone, eyes pretreated with dexamethasone drops showed a significantly greater decrease in ocular pressure (mean +/- SD); the maximal decrease in 12 dexamethasone-treated patients was 3.5 +/- 1.9 mm Hg (15.9% from baseline). Six dexamethasone-treated patients had a response of 4.0 to 6.0 mm Hg, whereas three showed responses < 4 and > 2 mm Hg with three < or = 2 mm Hg. CONCLUSIONS: This synergistic effect of timolol with dexamethasone on lowering of ocular pressure offers a potential therapeutic use in ocular hypertension and glaucoma.

Administration, Topical↗

PubMed1975

Electron-capture GLC determination of timolol in human plasma and urine.

A GLC procedure was developed for measuring nanogram quantities of timolol in plasma and urine. The unchanged drug was extracted into heptane-4% isoamyl alcohol from alkalinized plasma or urine, together with a homolog of timolol which served as the internal standard. The compounds were subsequently back-extracted into 0.1 N HC1 and then into chloroform following adjustment of the acid phase to an alkaline pH. The compounds in the chloroform extract were derivatized with heptafluorobutyrylimidazole to form the diheptafluorobutyryl derivatives; these were quantitated by electron-capture GLC. Recovery of timolol added to normal plasma and urine was quantitative and reproducible, and no interfering substances were observed in normal biological samples. The method is capable of measuring concentrations as low as 2 ng/ml in plasma or 20 ng/ml in urine. After a 10-mg oral dose of 14C-timolol, peak plasma levels of approximately 30 ng/ml were ovserved in 1-2 hr.

Humans↗

PubMed1976

Antihypertensive therapy with timolol and alpha-methyldopa. A double-blind trial in patients with moderately severe hypertension.

After 24 moderately severe hypertensive patients had been treated for 4 weeks with a placebo for timolol, alpha-methyldopa was added and titrated until control of the blood pressure or a total daily dose of 2 500 mg was achieved. At the 9th week, the dose of alpha-methyldopa was halved and either timolol or its placebo was titrated in double-blind fashion. Titration over a period of 4 weeks was followed by a further 5 weeks of stabilisation. In 22 patients whose responses were accepted for analysis, alpha-methyldopa caused a significant lowering of blood pressure, with a greater reduction in the upright posture and a reduction in pulse rate. The addition of timolol caused a highly significant further reduction in pulse rate and a significant reduction in blood pressure in 8 of 10 patients. Apart from a statistically significant increase in serum urea and creatinine with, however, retention of normal renal function, no other side-effects were attributable to timolol.

Adrenergic beta-Antagonists↗

PubMed1976

Intraocular pressure decrease in normal volunteers following timolol ophthalmic solution.

Timolol ophthalmic solutions 0.5 per cent, 1.0 per cent, and 1.5 per cent lowered intraocular pressures significantly in normal human volunteers. Maximum lowering of the intraocular pressures was reached at two hours with the 0.5 per cent solution of timolol and at one hour with the 1.0 per cent and 1.5 per cent timolol ophthalmic solutions. The effect lasted the full seven hours of observations. No objective or subjective evidence of ocular irritation could be attributed to the drug. A single dose of timolol applied topically to the eyes of normal human volunteers had no effect on pupillary size, visual acuity, blood pressure, or pulse rate.

Adrenergic beta-Antagonists↗

PubMed2005

Twenty-four-hour control with latanoprost-timolol-fixed combination therapy vs latanoprost therapy.

OBJECTIVE: To evaluate the 24-hour efficacy and safety of the latanoprost-timolol maleate-fixed combination vs latanoprost therapy in patients with primary open-angle glaucoma. METHODS: A prospective, observer-masked, crossover, active-controlled, randomized comparison in which after a 6-week medicine-free period, patients were randomized to either latanoprost-timolol-fixed combination therapy or latanoprost therapy, both dosed once each evening, alone for 8 weeks. Patients were then switched to the opposite treatment for 8 weeks. At the end of the washout and treatment periods, a 24-hour diurnal curve was performed. RESULTS: The baseline untreated mean +/- SD diurnal curve in 37 patients who completed the study was 24.2 +/- 2.0 mm Hg. The mean diurnal curve was 19.2 +/- 2.6 mm Hg for those who received latanoprost therapy alone and 16.7 +/- 2.1 mm Hg for those who received the fixed combination therapy (P<.001). The fixed combination therapy also provided a lower absolute intraocular pressure level (1.5-2.9 mm Hg, P<.001) and a greater intraocular pressure reduction from the untreated baseline (P<.001). Stinging was statistically lower with latanoprost therapy alone (P = .04), but itching was statistically increased compared with the fixed combination therapy (P = .04). CONCLUSION: The result of this study suggests that the latanoprost-timolol-fixed combination compared with latanoprost therapy alone provides improved intraocular pressure reduction over the 24-hour diurnal curve and for each individual time point in patients with primary open-angle glaucoma.

Aged↗

PubMed1977

Timolol. A beta-adrenergic blocking agent for the treatment of glaucoma.

Timolol maleate, a beta-adrenergic blocking agent, was studied in 30 patients with glaucoma. Significant intraocular pressure lowering was achieved with 0.5% and 1.5% solution of the drug. At seven hours following treatment, the IOP was lowered 50% from the pretreatment pressure with both strengths of timolol. There were no subjective or objective ocular or systemic side effects detected. Visual acuity and pupil response were unchanged from pretreatment levels throughout the study. beta-Adrenergic blocking agents and specifically timolol may be an important breakthrough for the medical management of glaucoma.

Clinical Trials as Topic↗

PubMed1977

Timolol, dose response and duration of action.

Timolol maleate, a beta-adrenergic blocking agent, was used in a study of 20 adult patients with chronic open-angle glaucoma. This single-dose study demonstrated a dose response for this drug using concentrations of 0.1%, 0.25%, 0.5%, and 1.0%. Timolol, 0.5%, appears to give the maximal ocular hypotensive effect; however, each concentration of the drug produced an ocular hypotensive effect for at least 24 hours. No local or systemic side effects were discovered throughout the study. Timolol may be an effective, innocuous, once-a-day, topical agent for the treatment of glaucoma.

Adult↗

PubMed1980

Comparison between pilocarpine and timolol on diurnal pressures in open-angle glaucoma.

In 14 eyes with open-angle glaucoma, 2% pilocarpine hydrochloride given four times a day was compared with timolol given twice daily in its effect on intraocular pressure around the clock. The findings suggest that the timolol produced a greater reduction in pressure than pilocarpine and that, in 50% of the diurnal curves, the timolol curve showed smaller swings in IOP.

Circadian Rhythm↗

PubMed1981

Fluorophotometric study of epinephrine and timolol in human subjects.

The action and interaction of topical 2% epinephrine hydrochloride and 0.5% timolol maleate therapy were studied in 12 normal and 16 ocular hypertensive subjects. Measurements of intraocular pressure, outflow facility, and aqueous secretion by fluorophotometry were made. Uveoscleral outflow values were calculated. Epinephrine, applied topically twice daily for one week, resulted in a decrease in IOP of 3.3 +/- 0.9 mm Hg and an increase in outflow facility of 0.05 +/- 0.01 microL/min/mm Hg, as well as an increase in the rate of aqueous production of 0.32 +/- 0.09 microL/min. Uveoscleral outflow showed an increase of 0.83 +/- 0.23 microL/min. Timolol, applied topically twice daily for one week, reduced the IOP 3.9 +/- 1.0 mm Hg and decreased aqueous flow 0.84 +/- 0.23 microL/min, but produced no change in outflow facility or uveoscleral flow. When epinephrine and timolol are given in combination, the effects in lowering IOP may not be completely additive.

Aqueous Humor↗