Different intraocular pressure-lowering effects of latanoprostene bunod across glaucoma subtypes: a 12-month...

To compare the reduction in intraocular pressure (IOP) over 12 months after switching from latanoprost to latanoprostene bunod (LBN) in different glaucoma subtypes, including primary open-angle glaucoma (POAG), pseudoexfoliation glaucoma (PXFG), and neovascular glaucoma (NVG), and to assess the clinical significance of any differential IOP response.

We conducted a retrospective chart review of 103 patients with POAG (n = 42), PXFG (n = 30), or NVG (n = 31) who were treated with latanoprost 0.005% and switched to LBN monotherapy (0.024%). All other ocular hypotension treatments remained unchanged. The IOP was recorded at baseline and 1, 3, 6, and 12 months after switching. Repeated-measures ANOVA was used to assess the longitudinal IOP changes within groups, and between-group differences were evaluated using one-way ANOVA, followed by post-hoc testing.

The baseline IOP was significantly higher in the NVG group compared to the POAG group. At 12 months, the mean IOP reductions were - 9.9% in POAG (p < 0.001 vs. baseline), - 16.7% in PXFG (p < 0.001), and - 1.4% in NVG (p = 0.63). PXFG eyes experienced significantly greater IOP lowering than POAG (p = 0.033) and NVG (p < 0.001), while the NVG eyes derived no meaningful benefit.

LBN demonstrated differential IOP-lowering effects across glaucoma subtypes, with a notably enhanced effect on PXFG. This superior efficacy in PXFG, likely due to LBN's dual mechanism overcoming pseudoexfoliative outflow resistance, suggests that switching from latanoprost may help delay the need for surgical intervention in this challenging patient population.