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Drug offers more options for glaucoma sufferers

Better results, easier use. That's the buzz surrounding latanoprost, the newest medication for treating glaucoma.

As the leading cause of vision loss and blindness in the United States, glaucoma affects about 2 million Americans every year. This virtually symptomless condition occurs when normal eye fluids build up, increasing eye pressure. Over time, this excessive pressure obstructs blood vessels in the eye and keeps them from nourishing the optic nerve. As the optic nerve degenerates, so, too, does vision.

Unlike current glaucoma drugs that attempt to slow the production of eye fluids (timolol maleate, for example), latanoprost works by speeding up the fluid's drainage. Experts believe it is this slow outflow of fluid, not excess production, that is the greater contributor to high eye pressure. Two recent studies support this view.

In a 3- and a 6-month study, latanoprost lowered eye pressure slightly more effectively than timolol--27% vs. 20%. More important, it did so without noticeable systemic side effects and was easier to use.

Latanoprost is admin-istered only once a day (in the form of eyedrops) vs. twice a day for timolol. Plus, since latanoprost is a more potent drug, the size of the drop that patients put in their eyes is less--about 1/100th the amount of timolol (Oph-thalmology, January 1996, and Archives of Ophthalmology, August 1996).

"We're hoping latanoprost will emerge as the 'magic bullet' for glaucoma treatment," says Thom Zimmer-man, MD, PhD, chairman of ophthalmology at the University of Louis-ville, KY. So far, only one problem keeps it from being the first drug-of-choice for glaucoma. Four of the 128 latanoprost-using patients in one of the studies showed a slight change in eye color. The circular darkening on the outside of the iris, which may or may not be permanent, did not appear to harm the eye.

Until the mystery is solved, the FDA has limited latanoprost's use to people who are not responding to or cannot take (due to asthma or certain heart conditions) other glaucoma medications. Given the drug's otherwise strong track record, if you fall into one of these categories, taking latanoprost may well be worth talking about with your ophthalmologist.

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By Yun Lee Wolfe

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