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Abstract #27585 Published in IGR 12-4
Intraocular pressure changes in the contralateral eye after topical treatment: Does an 'ophthalmotonic consensual reaction' exist?
Newman H; Kurtz S; David RIsraeli Medical Association Journal 2010; 12: 568-571
See also comment(s) by Tony Realini •
Background: The existence of "ophthalmotonic consensual reaction," a contralateral change in intraocular pressure in the fellow eye induced by treatment of the first eye only, was suggested in 1924. Since then, the validity of this mechanism has been controversial. Objectives: To assess intraocular pressure changes in the contralateral fellow eyes of patients treated with IOP-lowering medication in one eye, and investigate the existence of an ophthalmotonic consensual reaction. methods: The study population included 38 patients with newly diagnosed bilateral ocular hypertension or early open angle glaucoma. One eye of each patient was randomly treated with one of five compounds: prostaglandin analogues, beta-blockers, alpha-2 agonists, carbonic anhidrase inhibitors and a combination therapy: dorzolamide hydrochloridetimolol maleate (Cosopt(registered trademark), Merck Sharpe & Dohme). The eye with the higher baseline IOP was selected to be the treated eye. After 3 weeks a masked examiner measured the IOP in both the treated and untreated eye. results: Mean IOP of the treated eyes at baseline was 26.1 (plus or minus) 4.2 mmHg and at follow-up 20.2 (plus or minus)2.9 mmHg, a reduction of IOP from baseline of -6 (plus or minus) 3.8 mmHg, a mean percent reduction of -22 (plus or minus) 10.1%. In the contralateral eyes, the mean IOP at baseline was 24.2 (plus or minus) 3 mmHg and 23.1 (plus or minus) 3.1 mmHg at follow-up; IOP reduction from baseline was -1.2 (plus or minus) 1.8 mmHg, or mean percent reduction -4.7 (plus or minus) 7.1%. A major contralateral IOP decrease was seen only in the beta-blockers and the combination (Cosopt(registered trademark)) treatment groups (-6.1 (plus or minus) 8.3% and -12.3 (plus or minus) 8.3% mean percent reduction, respectively, P < 0.05). The contralateral eyes in the prostaglandin analogues, CAI or (alpha)2-agonist groups showed only a small change in IOP (-2.6 (plus or minus) 4.6%, -3.2 (plus or minus) 2.6%, +0.7 (plus or minus) 3.3%, mean percent reduction, respectively, P < 0.05). conclusions: The existence of an ophthalmotonic consensual reaction was not supported.
H. Newman. Dept. of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv 64239, Israel. hadasng@gmail.com