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Aim To determine the glaucoma specialists' preferences for the different brands of topical glaucoma medications available in Mexico. Materials and methods A web-based survey was sent to 150 board-certified glaucoma specialists in Mexico, with 14 questions related to brand preferences for all glaucoma medications available in Mexico. Participants were asked to select each glaucoma medication class by brand and to state the factors leading to their choice. Results Data from 111 (74%) glaucoma specialists were collected. Imot (timolol 0.5%; Sophia, Mexico) was the preferred brand for the beta-blockers (BB) class by 71% (n = 79) of the participants. Azopt (brinzolamide 1%; Alcon Lab, US) was the preferred carbonic anhydrase inhibitor (CAI) by 54% (n = 60) of the glaucoma specialists. Lumigan (bimatoprost 0.01% and 0.03%; Allergan Inc., U.S.) was the first choice for the prostaglandin analogues (PGAs) in 62% (n = 70) of the answers. The most frequently prescribed alpha-agonist (AA) was Agglad (brimonidine 0.2%; Sophia Lab, Mexico) in 44% (n = 49) of the answers. Medication accessibility (31%), cost (29%), and recommended dose (23%) were the three main factors influencing the glaucoma specialists' preferences. Conclusion Medication cost and accessibility, as well as posology, remain the main factors influencing brand preferences among glaucoma doctors. In our professional opinion, the therapeutic effect must be the leading factor when prescribing topical medications in the daily practice, so that patients receive the best treatment option. Clinical significance This survey provides an understanding of the decision-making process when prescribing glaucoma medications by glaucoma specialists in a Latin American developing country. Ideally, patient treatment should be individualized and aimed to achieve the best results possible for their specific condition. How to cite this article Lazcano-Gomez G, Alvarez-Ascencio D, Haro-Zuno C, Turati-Acosta M, Garcia-Huerta M, Jimenez-Arroyo J, Castañeda-Diez R, Castillejos-Chevez A, Gonzalez-Salinas R, Dominguez-Dueñas F, Jimenez-Roman J. Glaucoma Medication Preferences among Glaucoma Specialists in Mexico. J Curr Glaucoma Pract 2017;11(3):97-100.

The aim of the study was to disclose a realistic estimate of primary open-angle glaucoma treatment, follow-up costs, and patients’ monthly glaucoma-economic burden in an ophthalmology hospital in Mexico City. Prospective survey of 462 primary open-angle glaucoma patients from 2007 to 2012 was carried out. Costs from visits, glaucoma follow-up studies, laser, and glaucoma surgical procedures were obtained from hospital pricings. Education, employment, and monthly income were interrogated. Total cost was divided into hypotensive treatment cost, nonpharmacologic treatment cost (laser and surgeries), and follow-up studies and consults. Average wholesale price for drugs analyzed was obtained from IMS Health data; monthly cost was calculated using: Monthly cost = ([average wholesale price/number of drops per eye dropper] × number of daily applications) × 30 days. Patients were classified according to their glaucoma severity, and data were analyzed based on monthly income (average annual exchange rate: 12.85 Mexican pesos = 1 USD). The mean age was 70 ± 10 years, women = 81%, elementary school = 39%, and unemployed = 53%. Low-income group = 266 patients (57%), 146 with mild glaucoma; moderate-income group = 176 patients (38%), 81 with mild glaucoma; high-income group = 20 patients (4.3%), 10 with mild glaucoma. Patients’ monthly average economic burden in glaucoma treatment: low-income patients = 61.5%, moderate-income patients = 19.5%, and high-income patients = 7.9%. Glaucoma-economic burden is substantial not only for health systems, but for the family and the patient. Therefore, screening plans for earlier diagnosis, and health policies that lessen the cost of disease management and increase adherence to treatment, and reduce the prevalence of blindness attributed to glaucoma are essential. These would improve quality of life, reduce personal and national expenditure, and help increase national economy.

ResumenObjetivosEvaluar los resultados de las pruebas de sobrecarga hídrica (SH) y estimación de presión intraocular o prueba de Borrone, en pacientes con glaucoma primario de ángulo abierto comparándolos con el estudio de curva tensional horaria.Material y métodoA un mismo grupo de pacientes con diagnóstico de glaucoma primario de ángulo abierto se les realizó curva tensional horaria y se compararon los resultados de variabilidad de la presión intraocular con los obtenidos mediante la prueba de sobrecarga hídrica y con la prueba de Borrone.ResultadosLa variación promedio de la presión intraocular en la curva horaria tensional fue de 4.05±1.57mmHg, en la prueba de SH fue de 3.55±1.5mmHg y en el método de Borrone de 2.55±2.83mmHg. La diferencia entre la variación medida con curva diurna y Borrone fue estadísticamente significativa (p=0.025). La diferencia entre la variación medida con la curva horaria y SH no fue estadísticamente significativa (p=0.374). Los resultados de las pruebas de Borrone y SH concordaron con la curva tensional horaria solamente en un 40% de los ojos cada una.AbstractObjetivesTo evaluate de results of the water drinking test and Borrone test in patients with primary open angle glaucoma, comparing it with 24hr tensional curve.Material and methodsTo the same group of patients a 24hr tensional curve was perfomed and the results were compared with the Borrone test and the water drinking test.ResultsThe average of intraocular pressure fluctuation was 4.05±1.57mmHg in the 24hr tensional curve, for the water drinking test was 3.55±1.5mmHg and for Borrone test was 2.55±2.83mmHg. The difference of the results between the 24hr tensional curve and Borrone test were statistically significant. The difference of the results between the 24hr tensional curve and water drinking test were not statistically significant. We observed just a 40% of concordance between both the Borrone test and water drinking test with the 24hr tensional curve.ConclusionsIn the present study the Borrone test and the water drinking test obtained a low correlation with the 24hr tensional curve which is considered the gold standard.