Do Ripasudil or Travoprost Provide Any Quantitative Nerve Fibre Layer Protection along with Decrease in Intraocular Pressure? A Comparative Short-Term Study in Primary Open Angle Glaucoma

Purpose: To evaluate the effect of ripasudil versustravoprost on intraocular pressure and retinal nerve fibre layer in patients suffering from primary open angle glaucoma (POAG). Design: A single center, prospective, interventional, parallel group, hospital based randomized comparative study. Method: Fourty eyes of fourty patients suffering from POAG were medically treated with ripasudil or travoprost by randomizing them into 2 groups for a period of 6 months and studying their effects on intraocular pressure and retinal nerve fibre layer. Results: A total of 40 patients were enrolled, 20 randomized to ripasudil groupand 20 randomised to travoprost group. The mean age being 53.00?16.94 years in ripasudil group and 52.15?15.97 years (p value 0.871). The baseline intraocular pressures for ripasudil and travoprost from their baseline of 23.50?2.04 mmHg and 23.95?2.24 mmHg dropped to 19.00?2.45 mmHg and 16.95?2.44 mmHg on their last visit respectively (p value less than 0.001). The baseline retinal nerve fibre thickness for ripasudil group was 117.40?12.19 microns and on last follow up at 6 months was 112.85?14.08 microns, with a change of 4.55?4.36 microns (p value less than0.001). The baseline retinal nerve fibre thickness for travoprost group was 115.25?11.44 microns and on last follow up at 6 months was 111.10?13.29 microns, with a change of 4.15?4.32 microns (p value less than0.001). Conclusion: Travoprost showed greater intraocular pressure lowering effect than ripasudil. And ripasudil and travoprost showedno statistically significant retinal nerve fibre layer protective effects in our study.