Twelve studies involving 3048 patients with open-angle glaucoma or ocular hypertension were included in the meta-analysis comparing timolol with prostaglandin analogs «Li N, Chen XM, Zhou Y ym. Travoprost compared with...»1. Participants received either travoprost, other prostaglandin analog or timolol.
Ocular hyperaemia was the most common side-effect of prostaglandin analogues. The combined results suggested that travoprost 0.004 % caused a higher percentage of ocular hyperaemia than timolol 0.5 % (OR = 6.76, 95 % CI 4.93-9.25, P < 0.00001), or latanoprost 0.005 % (OR = 2.03, 95 % CI 1.49-2.75, P = 0.00001) and travoprost 0.0015 % (OR = 1.64, 95 % CI 1.32-2.04, P = 0.00001). However, there was no statistically significant difference between travoprost 0.004 % and bimatoprost 0.03 % (OR = 0.65, 95 % CI 0.42.1.00, P = 0.05) in hyperaemia.
In another meta-analysis comparing latanoprost with timolol in patients with open-angle glaucoma «Zhang WY, Po AL, Dua HS ym. Meta-analysis of rando...»2, latanoprost caused hyperaemia and iris pigmentation more often than timolol (RR = 2.20, 95 % CI 1.33-3.65). The number needed to harm was 21 (CI 14-42) when compared to timolol.
A systematic review compared timolol with brimonidine (α2 adrenergic agonist), prostaglandin analogs (travoprost, latanoprost), other β adrenergic antagonists, and placebo «Boland MV, Ervin AM, Friedman DS ym. Comparative e...»3. As to the comparison of timolol with prostaglandin analogs, participants receiving either travoprost or latanoprost had six times the odds and twice the odds (OR, 6.76, CI 4.93-9.25 and OR 2.03, CL 1.49-2.75), respectively, of dropping out of the study due to conjuctival hyperemia, compared to patients receiving timolol.