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Abstract #8065 Published in IGR 4-3
The effect of dorzolamide on intraocular pressure and ocular pulse amplitude: adjunctive therapy to beta-blockers as a substitute for pilocarpine or as a second-line therapeutic agent in patients with open-angle glaucoma
Alimgil ML; Benian OEastern Journal of Medicine 2002; 7: 1-5
OBJECTIVE: To evaluate the effect of dorzolamide on the intraocular pressure (IOP), ocular pulse amplitude (OPA), systemic blood pressure, and pulse rate in open-angle glaucoma patients using a beta-blocker and 2% pilocarpine combination and beta-blocker monotherapy. The secondary aim was to find out the effect of dorzolamide on IOP and OPA in patients using selective versus nonselective beta-blocker. METHODS: Thirteen patients who had beta-blocker and pilocarpine combination (Group 1) and 15 patients who had beta-blocker monotherapy (Group 2) were enrolled. A randomly selected eye of bilaterally affected patients was included in the observer-blinded and parallel-group study. Baseline data consisted of four daytime IOP, OPA, systemic blood pressure and pulse rate measurements. Patients in Group 1 discontinued pilocarpine and used beta-blocker-dorzolamide combination, and patients in Group 2 used dorzolamide as a second-line therapeutic agent with a beta-blocker. The same measurements were performed after four weeks and after six months in both groups. RESULTS: In Group 1 the baseline IOP was 18.92.2 mmHg; after four weeks and six months, no statistically significant change was observed (17.62.3 and 17.83.2 mmHg respectively, p > 0.05). However in Group 2, a statistically significant IOP decrease from 22.5 3.3 to 18.0 2.0 mmHg after four weeks (p < 0.05) and to 18.4 1.8 mmHg after six months (p < 0.05) occurred. There were no changes in OPA, systemic blood pressure and pulse rate in either groups during the follow-up period. The additive effect of dorzolamide with selective and nonselective beta-blockers was analyzed using a cross-sectional study design of the data obtained from 28 eyes. Twelve patients who used selective beta-blocker and dorzolamide showed an increase in IOP (from 18.42.3 to 19.31.9 mmHg, p > 0.05) and a decrease in OPA (from 3.71.2 to 3.20.9 mmHg, p < 0.05) after five months, although these changes were not statistically significant. The IOP was stable during the same period (1 7.32.0 and 17.22.6 mmHg, p > 0.05) but the OPA showed a slight, but not significant increase (2.71.1 and 3.11.5 mmHg, p < 0.05) in 16 patients using nonselective beta-blocker and dorzolamide. CONCLUSIONS: Dorzolamide is safe and effective when used with beta-blockers, but its interaction with selective and nonselective beta-blockers needs further investigation.
M.L. Alimgil, MD, Trakya Universitesi Tip Fakultesi, Goz Hastaliklari AD, 22030 Edirne, Turkey
Classification:
11.5.2 Topical (Part of: 11 Medical treatment > 11.5 Carbonic anhydrase inhibitors)
