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Jeffrey M. Liebmann - One of the best experts on this subject based on the ideXlab platform.

  • risk factors for visual field progression in the low pressure glaucoma treatment study
    American Journal of Ophthalmology, 2012
    Co-Authors: David S. Greenfield, Jeffrey M. Liebmann, Robert Ritch, Stuart K Gardiner, Carlos Gustavo De Moraes, Theodore Krupin
    Abstract:

    Purpose To investigate risk factors associated with visual field progression in the Low-pressure Glaucoma Treatment Study, a prospective trial designed to compare the effects of the alpha2-adrenergic agonist brimonidine tartrate 0.2% to the Beta-Adrenergic Antagonist timolol maleate 0.5% on visual function in low-pressure glaucoma. Design Prospective cohort study. Methods Low-pressure Glaucoma Treatment Study patients with ≥5 visual field tests during follow-up were included. Progression was determined using pointwise linear regression analysis, defined as the same 3 or more visual field locations with a slope more negative than −1.0 dB/year at P Results A total of 253 eyes of 127 subjects (mean age, 64.7 ± 10.9 years; mean follow-up, 40.6 ± 12 months) were analyzed. Eyes randomized to timolol progressed faster than those randomized to brimonidine (mean rates of progression, −0.38 ± 0.9 vs 0.02 ± 0.7 dB/y, P P = .022), use of systemic antihypertensives (HR = 2.53, 95% CI=1.32 to 4.87, P = .005), and mean ocular perfusion pressure (HR = 1.21/mm Hg lower, 95% CI=1.12 to 1.31, P P Conclusions While randomization to brimonidine 0.2% was protective compared to timolol 0.5%, lower mean ocular perfusion pressure increased the risk for reaching a progression outcome in the Low-pressure Glaucoma Treatment Study. This suggests that the beneficial effect of randomization to the brimonidine arm was independent of possible differences in ocular perfusion pressures between the 2 treatment arms. The current results and large number of drop-outs in the brimonidine 0.2% arm suggest that more research is necessary before altering clinical practice paradigms.

  • a randomized trial of brimonidine versus timolol in preserving visual function results from the low pressure glaucoma treatment study
    American Journal of Ophthalmology, 2011
    Co-Authors: Theodore Krupin, David S. Greenfield, Jeffrey M. Liebmann, Robert Ritch, Stuart K Gardiner
    Abstract:

    Purpose To compare the alpha2-adrenergic agonist brimonidine tartrate 0.2% to the Beta-Adrenergic Antagonist timolol maleate 0.5% in preserving visual function in low-pressure glaucoma. Design Randomized, double-masked, multicenter clinical trial. Methods Exclusion criteria included untreated intraocular pressure (IOP) >21 mm Hg, visual field mean deviation worse than -16 decibels, or contraindications to study medications. Both eyes received twice-daily monotherapy randomized in blocks of 7 (4 brimonidine to 3 timolol). Standard automated perimetry and tonometry were performed at 4-month intervals. Main outcome measure was field progression in either eye, defined as the same 3 or more points with a negative slope ≥-1 dB/year at P Results Ninety-nine patients were randomized to brimonidine and 79 to timolol. Mean (± SE) months of follow-up for all patients was 30.0 ± 2. Statistically fewer brimonidine-treated patients (9, 9.1%) had visual field progression by pointwise linear regression than timolol-treated patients (31, 39.2%, log-rank 12.4, P=.001). Mean treated IOP was similar for brimonidine- and timolol-treated patients at all time points. More brimonidine-treated (28, 28.3%) than timolol-treated (9, 11.4%) patients discontinued study participation because of drug-related adverse events (P=.008). Similar differences in progression were observed when analyzed by GCPM and the 3-omitting method. Conclusion Low-pressure glaucoma patients treated with brimonidine 0.2% who do not develop ocular allergy are less likely to have field progression than patients treated with timolol 0.5%.

Robert Ritch - One of the best experts on this subject based on the ideXlab platform.

  • risk factors for visual field progression in the low pressure glaucoma treatment study
    American Journal of Ophthalmology, 2012
    Co-Authors: David S. Greenfield, Jeffrey M. Liebmann, Robert Ritch, Stuart K Gardiner, Carlos Gustavo De Moraes, Theodore Krupin
    Abstract:

    Purpose To investigate risk factors associated with visual field progression in the Low-pressure Glaucoma Treatment Study, a prospective trial designed to compare the effects of the alpha2-adrenergic agonist brimonidine tartrate 0.2% to the Beta-Adrenergic Antagonist timolol maleate 0.5% on visual function in low-pressure glaucoma. Design Prospective cohort study. Methods Low-pressure Glaucoma Treatment Study patients with ≥5 visual field tests during follow-up were included. Progression was determined using pointwise linear regression analysis, defined as the same 3 or more visual field locations with a slope more negative than −1.0 dB/year at P Results A total of 253 eyes of 127 subjects (mean age, 64.7 ± 10.9 years; mean follow-up, 40.6 ± 12 months) were analyzed. Eyes randomized to timolol progressed faster than those randomized to brimonidine (mean rates of progression, −0.38 ± 0.9 vs 0.02 ± 0.7 dB/y, P P = .022), use of systemic antihypertensives (HR = 2.53, 95% CI=1.32 to 4.87, P = .005), and mean ocular perfusion pressure (HR = 1.21/mm Hg lower, 95% CI=1.12 to 1.31, P P Conclusions While randomization to brimonidine 0.2% was protective compared to timolol 0.5%, lower mean ocular perfusion pressure increased the risk for reaching a progression outcome in the Low-pressure Glaucoma Treatment Study. This suggests that the beneficial effect of randomization to the brimonidine arm was independent of possible differences in ocular perfusion pressures between the 2 treatment arms. The current results and large number of drop-outs in the brimonidine 0.2% arm suggest that more research is necessary before altering clinical practice paradigms.

  • a randomized trial of brimonidine versus timolol in preserving visual function results from the low pressure glaucoma treatment study
    American Journal of Ophthalmology, 2011
    Co-Authors: Theodore Krupin, David S. Greenfield, Jeffrey M. Liebmann, Robert Ritch, Stuart K Gardiner
    Abstract:

    Purpose To compare the alpha2-adrenergic agonist brimonidine tartrate 0.2% to the Beta-Adrenergic Antagonist timolol maleate 0.5% in preserving visual function in low-pressure glaucoma. Design Randomized, double-masked, multicenter clinical trial. Methods Exclusion criteria included untreated intraocular pressure (IOP) >21 mm Hg, visual field mean deviation worse than -16 decibels, or contraindications to study medications. Both eyes received twice-daily monotherapy randomized in blocks of 7 (4 brimonidine to 3 timolol). Standard automated perimetry and tonometry were performed at 4-month intervals. Main outcome measure was field progression in either eye, defined as the same 3 or more points with a negative slope ≥-1 dB/year at P Results Ninety-nine patients were randomized to brimonidine and 79 to timolol. Mean (± SE) months of follow-up for all patients was 30.0 ± 2. Statistically fewer brimonidine-treated patients (9, 9.1%) had visual field progression by pointwise linear regression than timolol-treated patients (31, 39.2%, log-rank 12.4, P=.001). Mean treated IOP was similar for brimonidine- and timolol-treated patients at all time points. More brimonidine-treated (28, 28.3%) than timolol-treated (9, 11.4%) patients discontinued study participation because of drug-related adverse events (P=.008). Similar differences in progression were observed when analyzed by GCPM and the 3-omitting method. Conclusion Low-pressure glaucoma patients treated with brimonidine 0.2% who do not develop ocular allergy are less likely to have field progression than patients treated with timolol 0.5%.

Theodore Krupin - One of the best experts on this subject based on the ideXlab platform.

  • risk factors for visual field progression in the low pressure glaucoma treatment study
    American Journal of Ophthalmology, 2012
    Co-Authors: David S. Greenfield, Jeffrey M. Liebmann, Robert Ritch, Stuart K Gardiner, Carlos Gustavo De Moraes, Theodore Krupin
    Abstract:

    Purpose To investigate risk factors associated with visual field progression in the Low-pressure Glaucoma Treatment Study, a prospective trial designed to compare the effects of the alpha2-adrenergic agonist brimonidine tartrate 0.2% to the Beta-Adrenergic Antagonist timolol maleate 0.5% on visual function in low-pressure glaucoma. Design Prospective cohort study. Methods Low-pressure Glaucoma Treatment Study patients with ≥5 visual field tests during follow-up were included. Progression was determined using pointwise linear regression analysis, defined as the same 3 or more visual field locations with a slope more negative than −1.0 dB/year at P Results A total of 253 eyes of 127 subjects (mean age, 64.7 ± 10.9 years; mean follow-up, 40.6 ± 12 months) were analyzed. Eyes randomized to timolol progressed faster than those randomized to brimonidine (mean rates of progression, −0.38 ± 0.9 vs 0.02 ± 0.7 dB/y, P P = .022), use of systemic antihypertensives (HR = 2.53, 95% CI=1.32 to 4.87, P = .005), and mean ocular perfusion pressure (HR = 1.21/mm Hg lower, 95% CI=1.12 to 1.31, P P Conclusions While randomization to brimonidine 0.2% was protective compared to timolol 0.5%, lower mean ocular perfusion pressure increased the risk for reaching a progression outcome in the Low-pressure Glaucoma Treatment Study. This suggests that the beneficial effect of randomization to the brimonidine arm was independent of possible differences in ocular perfusion pressures between the 2 treatment arms. The current results and large number of drop-outs in the brimonidine 0.2% arm suggest that more research is necessary before altering clinical practice paradigms.

  • a randomized trial of brimonidine versus timolol in preserving visual function results from the low pressure glaucoma treatment study
    American Journal of Ophthalmology, 2011
    Co-Authors: Theodore Krupin, David S. Greenfield, Jeffrey M. Liebmann, Robert Ritch, Stuart K Gardiner
    Abstract:

    Purpose To compare the alpha2-adrenergic agonist brimonidine tartrate 0.2% to the Beta-Adrenergic Antagonist timolol maleate 0.5% in preserving visual function in low-pressure glaucoma. Design Randomized, double-masked, multicenter clinical trial. Methods Exclusion criteria included untreated intraocular pressure (IOP) >21 mm Hg, visual field mean deviation worse than -16 decibels, or contraindications to study medications. Both eyes received twice-daily monotherapy randomized in blocks of 7 (4 brimonidine to 3 timolol). Standard automated perimetry and tonometry were performed at 4-month intervals. Main outcome measure was field progression in either eye, defined as the same 3 or more points with a negative slope ≥-1 dB/year at P Results Ninety-nine patients were randomized to brimonidine and 79 to timolol. Mean (± SE) months of follow-up for all patients was 30.0 ± 2. Statistically fewer brimonidine-treated patients (9, 9.1%) had visual field progression by pointwise linear regression than timolol-treated patients (31, 39.2%, log-rank 12.4, P=.001). Mean treated IOP was similar for brimonidine- and timolol-treated patients at all time points. More brimonidine-treated (28, 28.3%) than timolol-treated (9, 11.4%) patients discontinued study participation because of drug-related adverse events (P=.008). Similar differences in progression were observed when analyzed by GCPM and the 3-omitting method. Conclusion Low-pressure glaucoma patients treated with brimonidine 0.2% who do not develop ocular allergy are less likely to have field progression than patients treated with timolol 0.5%.

Carlos Gustavo De Moraes - One of the best experts on this subject based on the ideXlab platform.

  • risk factors for visual field progression in the low pressure glaucoma treatment study
    American Journal of Ophthalmology, 2012
    Co-Authors: David S. Greenfield, Jeffrey M. Liebmann, Robert Ritch, Stuart K Gardiner, Carlos Gustavo De Moraes, Theodore Krupin
    Abstract:

    Purpose To investigate risk factors associated with visual field progression in the Low-pressure Glaucoma Treatment Study, a prospective trial designed to compare the effects of the alpha2-adrenergic agonist brimonidine tartrate 0.2% to the Beta-Adrenergic Antagonist timolol maleate 0.5% on visual function in low-pressure glaucoma. Design Prospective cohort study. Methods Low-pressure Glaucoma Treatment Study patients with ≥5 visual field tests during follow-up were included. Progression was determined using pointwise linear regression analysis, defined as the same 3 or more visual field locations with a slope more negative than −1.0 dB/year at P Results A total of 253 eyes of 127 subjects (mean age, 64.7 ± 10.9 years; mean follow-up, 40.6 ± 12 months) were analyzed. Eyes randomized to timolol progressed faster than those randomized to brimonidine (mean rates of progression, −0.38 ± 0.9 vs 0.02 ± 0.7 dB/y, P P = .022), use of systemic antihypertensives (HR = 2.53, 95% CI=1.32 to 4.87, P = .005), and mean ocular perfusion pressure (HR = 1.21/mm Hg lower, 95% CI=1.12 to 1.31, P P Conclusions While randomization to brimonidine 0.2% was protective compared to timolol 0.5%, lower mean ocular perfusion pressure increased the risk for reaching a progression outcome in the Low-pressure Glaucoma Treatment Study. This suggests that the beneficial effect of randomization to the brimonidine arm was independent of possible differences in ocular perfusion pressures between the 2 treatment arms. The current results and large number of drop-outs in the brimonidine 0.2% arm suggest that more research is necessary before altering clinical practice paradigms.

James M Odonnell - One of the best experts on this subject based on the ideXlab platform.

  • antidepressant like effects of rolipram and other inhibitors of cyclic adenosine monophosphate phosphodiesterase on behavior maintained by differential reinforcement of low response rate
    Journal of Pharmacology and Experimental Therapeutics, 1993
    Co-Authors: James M Odonnell
    Abstract:

    Four inhibitors of cyclic AMP phosphodiesterase (PDE), rolipram, Ro 20-1724, ICI 63,197 and CP 76,593, reduced response rates and increased reinforcement rates of rats under a differential reinforcement of low rate 72-sec schedule for water reinforcement in a dose-dependent manner. These actions of the PDE inhibitors are similar to those reported for proven antidepressant drugs. Administration of forskolin, which increases cyclic AMP levels by activation of the catalytic subunit of adenylyl cyclase, either i.p. or i.c.v. did not mimic the effects of the PDE inhibitors. The behavioral effects of the PDE inhibitors were not antagonized by the beta adrenergic Antagonist propranolol, suggesting that these drugs were not altering behavior via an increase in norepinephrine release and an indirect stimulation of beta adrenergic receptors. 6-Hydroxydopamine-induced lesions of noradrenergic neurons increased sensitivity to rolipram. This suggests that alterations in PDE activity with a concomitant increase in sensitivity to PDE inhibitors may occur subsequent to functional denervation.

  • effects of the beta 2 adrenergic agonist zinterol on drl behavior and locomotor activity
    Psychopharmacology, 1993
    Co-Authors: James M Odonnell
    Abstract:

    The purpose of the present study was to assess the behavioral effects of the beta adrenergic agonist zinterol and to determine whether its actions were mediated by beta adrenergic receptors. Zinterol reduced response rate and increased reinforcement rate of rats under a differential-reinforcement-of-low-rate schedule in a dose-dependent manner; significant decreases in response rate and increases in reinforcement rate were observed at doses of 0.1–1 mg/kg. The effect of 0.3 mg/kg zinterol on this behavior was blocked by pretreatment with the beta adrenergic Antagonist propranolol. Zinterol also reduced locomotor activity in a dose-dependent manner; significant reductions were observed at doses of 0.3–10 mg/kg. Similarly, the effect of 1 mg/kg zinterol on locomotor activity was antagonized by propranolol. These effects of zinterol were similar to those of other beta adrenergic agonists as well as those of antidepressant drugs. Although the site of action (central versus peripheral) of zinterol was not determined in the present study, an experiment was carried out to determine if zinterol could act centrally after peripheral administration. The ability of repeated, systemic administration of zinterol to reduce the density of beta adrenergic receptors in cerebral cortex and cerebellum was determined. Repeated treatment with a high dose of zinterol (10 mg/kg, IP) reduced the density of beta adrenergic receptors in these brain regions, suggesting that, at least under certain conditions, systemically administered zinterol did have access to the central nervous system.