[Timolol topical ophthalmic combination]

The primary standard therapy in patients with open-angle glaucoma and ocular hypertension is carried out by means of monotherapy with synthetic prostaglandin analogues. Most of the glaucoma patients need more than one medication for adequate intraocular pressure control. Timolol represents the basic component of these combinations. Timolol topical ophthalmic combinations with dorzolamide (Cosopt), pilocarpine, latanoprost (Xalacom), travoprost and unoprostone are thoroughly described. Most antiglaucoma medications achieve on one side directly baroprotection by decreasing intraocular pressure and on the other side they produce indirectly vasoprotection, that is secondary to intraocular pressure lowering. The Cosopt, due to its Dorzolamide component, makes an exception since it produces directly both baroprotection by aqueous humor flow suppression and vasoprotection by increasing the blood flow within the retina, choroid, optic nerve head and retrobulbar area. Given these considerations as well as the fact that the ocular hypotensive effect of both the Cosopt and the latanoprost are equally potent, a question seems reasonable according to accepted standard i.e. Cosopt or latanoprost as primary glaucoma therapy?