Frequency of Use of Fixed-Combination Eye Drops by Patients with Glaucoma at Multiple Private Practices in Japan

Figures & data

Figure 1 The questionnaire for the survey.

Abbreviations: α₁-agonist, α₁-adrenergic agonist; α₂-agonist, α₂-adrenergic agonist; ALT, argon laser trabeculoplasty; CAI, carbonic anhydrase inhibitor; EP2, prostaglandin E₂ receptor 2; L, left; LI, laser iridotomy; NTG, normal-tension glaucoma; PACG, primary angle-closure glaucoma; PG, prostaglandin analog; POAG, primary open-angle glaucoma; R, right; ROCK, Rho-associated protein kinase; SLT, selective laser trabeculoplasty.

Table 1 The 78 Institutions Participating in the 2020 Survey

Fujita Eye Clinic	Toyama Eye Clinic	Hakuai Kobayashi Eye Clinic
Kinukawa Ganka	Oohara Ganka	Saihakuganka Clinics
Izumi Eye Clinic	Shinozaki Ekimae Takahashi Ophthalmology Clinic	Kugahara Eye Clinic
Sanai Ophthalmology Clinic	Miyazaki Ophthalmology Clinic	Fujiwara Eye Clinic
Saiki Eye Clinic	Hashida Eye Clinic	Kawazoe Eye Clinic
Ishii Eye Clinic	Soga Eye Clinic	Maki Ophthalmology Clinic
Yanagawa Ganka	Takanawadai Eye Clinic	Oharachika Ophthalmology Clinic
Fukasaku Ophthalmology	Waseda Ophthalmology Clinic	Kasai Ophthalmology
Tajima Eye & Plastic Clinic	Iogi Kikuchi Eye Clinic	Horikawa Eye Clinic
Aoyagi Eye Clinic	Inage Eye Clinic	Yanase Ophthalmology Clinic
Hongo Eye Clinic	Akatsuka Eye Clinic	Matobaganka Clinics
Yoshida Eye Clinic	Egi Eye Clinic	Nishikamata Eye Clinic
Noda Ganka Masuika Iin	Higako Ganka	Ogawa Eye Clinic
Miyake Eye Clinic	Goto Eye Clinic	Yoshida Eye Clinic
Takanedai Ophthalmology Clinic	Ogawa Eye Clinic	Shirokane Eye Clinic
Yatsu Ekimae Ajisai Ophthalmology Clinic	Nishifu Hikari Eye Clinic	Otakibashi Nishino Eye Clinic
Oami Eye Clinic	Dannoue Ophthalmology Clinic	Atsumi Clinic (Tokyo)
Nakayama Eye Clinic	Tsunashima-Ekimae Eye Clinic	Atsumi Clinic (Kakegawa)
Morichika Eye Clinic	Nakai Eye Center	Hayashi Ophthalmology Clinic
Nakazawa Eye Clinic	Saito Eye Clinic	Nakamura Ganka Keiseigeka
Komagome Mitsui Eye Clinic	Hillside Eye Clinic	Sakura Eye and Internal Medicine Clinic
Tachikawa Shindo Eye Clinic	Zushi Eye Clinic	Omiya Inouye Eye Clinic
Sugahara Eye Clinic	Imakoga Ophthalmology Clinic	Sapporo Inouye Eye Clinic
Ueda Eye Clinic	Murakami Eye Clinic	Nishikasai Inouye Eye Hospital
Emoto Eye Clinic	Gakiya Eye Clinic	Ochanomizu Inouye Eye Clinic
Ezure Ophthalmology Clinic	Kawashima Eye Clinic	Inouye Eye Hospital

Table 2 Comparison of Patients’ Characteristics in Previous Study and This Study (2016 and 2020)

	2020	2016	P
Number of patients	5303	4288
Mean ± standard deviation age, years	68.7±13.1	68.1±13.0	0.0108
Sex, men:women	2347:2956	1839:2449	0.1851
Type of glaucoma	NTG: 2710 POAG: 1638 Secondary glaucoma: 435 Ocular hypertension: 286 PACG: 225 Infantile glaucoma: 4 Others: 5	NTG: 2197 POAG: 1232 Secondary glaucoma: 378 Ocular hypertension: 242 PACG: 234 Infantile glaucoma: 5	0.9019 0.0222 0.2853 0.6205 0.0061 0.5252
History of glaucoma surgery/laser treatment	Surgery: 366	Surgery: 270	0.2479
	Laser: 220	Laser: 257	<0.0001
Mean ± standard deviation number of medications in use	1.8±1.3	1.7±1.2	0.0032

Abbreviations: NTG, normal-tension glaucoma; POAG, primary open-angle glaucoma; PACG, primary angle-closure glaucoma.

Figure 2 The details of medications used in the two-medications group.

Abbreviations: α2, α-2-adrenergic agonist; β, β-blocker; BRI, brinzolamide; CAI, carbonic anhydrase inhibitor; CAR, carteolol; DOR, dorzolamide; LAT, latanoprost; PG, prostaglandin analog; ROCK, Rho-associated protein kinase; TAF, tafluprost; TIM, timolol; TRA, travoprost.

Table 3 Medications in Use in the Three-, Four-, Five-, and Six-Medications Groups

	2020		2016
	N	%	N	%
Three-medications group
CAI/β FC + PG analogs	270	35.8%	236	39.5%
PG/β FC + α2 agonist	115	15.3%	51	8.5%
PG/β FC + CAI (eye drops)	110	14.6%	58	9.7%
CAI/β FC + α2 agonist	37	4.9%	17	2.8%
Others	222	29.4%	236	39.5%
Four-medications group
CAI/β FC + PG analogs + α2 agonist	156	39.9%	120	43.3%
CAI/β FC + PG analogs + ROCK inhibitor	53	13.6%	27	9.7%
PG/β FC + CAI (eye drops) + α2 agonist	40	10.2%	29	10.5%
Others	142	36.3%	101	36.5%
Five-medications group
CAI/β FC + PG analogs + α2 agonist + ROCK inhibitor	91	56.9%	39	39.4%
PG/β FC + CAI (eye drops) + α2 agonist + ROCK inhibitor	32	20.0%	10	10.1%
Others	37	23.1%	50	50.5%
Six-medications group
CAI/β FC + PG analogs + α2 agonist + ROCK inhibitor + CAI (oral)	18	52.9%	13	54.2%
PG/β FC + CAI (eye drops) + CAI (oral) + α2 agonist + ROCK inhibitor	3	8.8%	1	4.2%
Others	13	38.2%	10	41.7%

Abbreviations: α2 agonist, α-2-adrenergic agonist; β, β-blocker; CAI, carbonic anhydrase inhibitor; FC, fixed combination; PG, prostaglandin analog; ROCK, Rho-associated protein kinase.

Figure 3 Comparison of fixed-combination medications used in the 2020 and 2016 surveys. **p<0.0001 (χ² test).

Abbreviations: α2, α-2-adrenergic agonist; β, β-blocker; CAI, carbonic anhydrase inhibitor; PG, prostaglandin analog.

Figure 4 Use of different types of PG/β fixed-combination medications.

Abbreviations: β, β-blocker; PG, prostaglandin analog.