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1 General aspects (0)   1.1 Epidemiology (6)   1.2 Population genetics (4)   1.3 Pathogenesis (8)   1.4 Quality of life (5)   1.5 Glaucomas as cause of blindness (4)   1.6 Prevention and screening (9) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (3)   2.2 Cornea (19)   2.3 Sclera (2)   2.4 Anterior chamber angle (6)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (10)     2.5.2 Schlemms canal (2)     2.5.3 Scleral outlet channels (1)   2.6 Aqueous humor dynamics (1)     2.6.1 Production (1)     2.6.2 Outflow (1)       2.6.2.1 Trabecular meshwork (3)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (6)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (0)   2.9 Ciliary body (2)   2.10 Lens (0)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (4)   2.13 Retina and retinal nerve fibre layer (23)   2.14 Optic disc (20)   2.15 Optic nerve (2)   2.16 Chiasma and retrochiasmal central nervous system (4)   2.17 Stem cells (4)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (1)   3.2 Electron microscopy (0)   3.3 Immunohistochemistry (2)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (0)     3.4.2 Gene studies (29)   3.5 Molecular biology incl. SiRNA (25)   3.6 Cellular biology (28)   3.7 Biochemistry (3)   3.8 Pharmacology (5)   3.9 Pathophysiology (8)   3.10 Immunobiology (5)   3.11 Pharmacogenetics (0)   3.12 Proteomics (3)   3.13 In vivo imaging (0)     3.13.1 Laser Scanning (0)       3.13.1.1 Confocal Scanning Laser Ophthalmoscopy (0)       3.13.1.2 Confocal Scanning Laser Polarimetry (0)     3.13.2 Optical Coherence Tomography (0)       3.13.2.1 Anterior Segment (0)       3.13.2.2 Posterior Segment (0)     3.13.3 RGC Imaging (1)     3.13.4 Other (0)   3.20 Other (0) 4 Tissue culture of ocular cells (0) 5 Experimental glaucoma; animal models (1)   5.1 Rodent (31)   5.2 Primates (4)   5.3 Other (12) 6 Clinical examination methods (0)   6.1 Intraocular pressure measurement; factors affecting IOP (2)     6.1.1 Devices, techniques (11)     6.1.2 Fluctuation, circadian rhythms (9)     6.1.3 Factors affecting IOP (19)   6.2 Tonography, aqueous flow measurement (see also 2.6) (0)   6.3 Biomicroscopy (slitlamp) (0)     6.3.1 Anterior segment (2)     6.3.2 Posterior segment (1)   6.4 Gonioscopy (1)   6.5 Ophthalmoscopy (0)   6.6 Visual field examination and other visual function tests (0)     6.6.1 Conventional manual (0)     6.6.2 Automated (15)     6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (11)   6.7 Electro-ophthalmodiagnosis (5)   6.8 Photography (0)     6.8.1 Anterior segment (5)     6.8.2 Posterior segment (9)   6.9 Computerized image analysis (0)     6.9.1 Laser scanning (0)       6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (8)       6.9.1.2 Confocal Scanning Laser Polarimetry (9)     6.9.2 Optical coherence tomography (0)       6.9.2.1 Anterior (3)       6.9.2.2 Posterior (25)     6.9.5 Other (0)   6.10 Fluorescein (ICG) angiography (0)     6.10.1 Anterior segment (0)     6.10.2 Posterior segment (0)   6.11 Bloodflow measurements (16)   6.12 Ultrasonography and ultrasound biomicroscopy (3)   6.13 Provocative tests (2)   6.19 Telemedicine (0)   6.20 Progression (10)   6.30 Other (2) 8 Refractive errors in relation to glaucoma (0)   8.1 Myopia (4)   8.2 Hypermetropia (0)   8.3 Contact lenses (0)   8.4 Refractive surgical procedures (5)   8.5 Other (0) 9 Clinical forms of glaucomas (0)   9.1 Developmental glaucomas (0)     9.1.1 Congenital glaucoma, Buphthalmos (11)     9.1.2 Juvenile glaucoma (8)     9.1.3 Syndromes of Axenfeld, Rieger, Peters, aniridia (2)     9.1.4 Other (0)   9.2 Primary open angle glaucomas (0)     9.2.1 Ocular hypertension (4)     9.2.2 Other risk factors for glaucoma (4)     9.2.3 Open angle glaucoma with elevated IOP (3)     9.2.4 Normal pressure glaucoma (11)   9.3 Primary angle closure glaucomas (0)     9.3.1 Acute primary angle closure glaucoma (pupillary block) (8)     9.3.2 Chronic primary angle closure glaucoma (pupillary block) (4)     9.3.3 Plateau iris syndrome (0)     9.3.4 Primary angle closure suspect (2)     9.3.5 Primary angle closure (0)     9.3.10 Other (0)   9.4 Glaucomas associated with other ocular and systemic disorders (0)     9.4.1 Steroid-induced glaucoma (6)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (1)       9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (1)       9.4.2.2 Posterior polymorphous dystrophy (0)       9.4.2.3 Fuchs' endothelial dystrophy (0)       9.4.2.5 Other (0)     9.4.3 Glaucomas associated with disorders of the iris and ciliary body (0)       9.4.3.1 Pigmentary glaucoma (1)       9.4.3.5 Other (1)     9.4.4 Glaucomas associated with disorders of the lens (1)       9.4.4.1 Exfoliation syndrome (11)       9.4.4.2 Glaucomas associated with cataracts (0)       9.4.4.3 Glaucomas associated with lens dislocation (0)       9.4.4.5 Other (2)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (0)       9.4.5.1 Neovascular glaucoma (6)       9.4.5.5 Other (6)     9.4.6 Glaucomas associated with inflammation, uveitis (8)     9.4.7 Glaucomas associated with ocular trauma (4)     9.4.8 Glaucomas associated with intraocular tumors (1)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (0)       9.4.10 Glaucomas associated with hemorrhage (3)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (2)       9.4.11.2 Glaucomas in aphakia and pseudophakia (2)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (5)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (6)     9.4.15 Glaucoma in relation to systemic disease (24)     9.4.20 Other (0) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (5) 11 Medical treatment (0)   11.1 General management, indication (11)   11.2 Cholinergic drugs (0)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (2)     11.3.4 Betablocker (4)     11.3.5 Other (0)   11.4 Prostaglandins (19)   11.5 Carbonic anhydrase inhibitors (0)     11.5.1 Systemic (0)     11.5.2 Topical (2)   11.6 Osmotic treatment (0)   11.7 Treatment of bloodflow (0)   11.8 Neuroprotection (35)   11.9 Gene therapy (4)   11.13 Combination therapy (1)     11.13.1 Betablocker and pilocarpine (0)     11.13.2 Betablocker and carbon anhydrase inhibitor (3)     11.13.3 Betablocker and brimonidine (2)     11.13.4 Betablocker and prostaglandin (3)     11.13.5 Other (0)   11.14 Investigational drugs; pharmacological experiments (24)   11.15 Other drugs in relation to glaucoma (14)   11.16 Vehicles, delivery systems, pharmacokinetics, formulation (14)   11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (9)   11.20 Other (0) 12 Surgical treatment (0)   12.1 General management, indication (3)   12.2 Laser iridotomy (5)   12.3 Laser iridoplasty (0)   12.4 Laser trabeculoplasty and other laser treatment of the angle (16)   12.7 Surgical iridectomy (2)   12.8 Filtering surgery (0)     12.8.1 Without tube implant (9)     12.8.2 With tube implant or other drainage devices (25)     12.8.3 Non-perforating (10)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (5)     12.8.11 Complications, endophthalmitis (12)   12.9 Trabeculotomy, goniotomy (3)   12.10 Cyclodestruction (5)   12.11 Cyclodialysis (1)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (1)     12.12.3 Phacoemulsification (8)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (15)   12.15 Capsulotomy (0)   12.16 Vitrectomy (0)   12.17 Anesthesia (2)   12.20 Other (2) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (0)   13.2 Outcome (0)     13.2.1 IOP (1)     13.2.2 Visual field (1)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (1)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (7) 15 Miscellaneous (19)

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Abstract #25952 Published in IGR 12-2

Brimonidine for glaucoma

Rahman MQ; Ramaesh K; Montgomery DM
Expert Opinion on Drug Safety 2010; 9: 483-491

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Importance of the field: Brimonidine is a drug used in the management of glaucoma throughout the world and is the most modern (alpha)2-adrenoceptor agonist available. This review comprehensively discusses the use of brimonidine for glaucoma. Areas covered in this review: A historical insight into the development of selective adrenergic glaucoma drugs is given, followed by a description of the mechanisms of action and a discussion of the main clinical trials investigating clinical applications. The safety of brimonidine is evaluated, and our expert opinion is provided on how brimonidine is used in our clinical practice. The most relevant literature on the role of brimonidine in glaucoma is discussed. What the reader will gain: A clear understanding of the role of brimonidine for glaucoma treatment, with an explanation of its efficacy, limitations and use in clinical practice. Take home message: Brimonidine is an effective drug for lowering intraocular pressure. It has potentially serious systemic effects in children, in whom it is contraindicated. Its use in adults is limited by its ocular side effects such as allergy. Brimonidine is, however, an important part of the range of intraocular pressure lowering drugs available to prescribers.

M. Q. Rahman. Gartnavel General Hospital, Tennent Institute of Ophthalmology, 1053 Great Western Road, Glasgow, G12 0YN, United Kingdom. mmnrahman@hotmail.com

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Classification:

11.3.3 Apraclonidine, brimonidine (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)

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