dorzolamide and Chronic-Disease

To compare the efficacy, adverse effects, and patient compliance of latanoprost monotherapy with unfixed combination therapy with 0.5% timolol maleate and 1% dorzolamide in the treatment of chronic primary angle-closure glaucoma (CACG), 36 Japanese patients with CACG following laser iridotomy (LPI) were treated for 12 weeks with instillation of latanoprost alone or with unfixed combination therapy of 0.5% timolol maleate and 1% dorzolamide hydrochloride. After 12 weeks of treatment, latanoprost reduced intraocular pressure (IOP) from 22.2 +/- 2.0 mmHg to 14.8 +/- 1.9 mmHg (33% reduction); timolol maleate and dorzolamide hydrochloride also reduced IOP from 22.5 +/- 2.2 mmHg to 17.1 +/- 2.7 mmHg (24% reduction). Latanoprost monotherapy significantly lowered IOP compared with unfixed combination therapy of 0.5% timolol maleate and 1% dorzolamide hydrochloride. Furthermore, a systemic adverse effect of bradycardia was not observed in the latanoprost monotherapy group. Concerning compliance, no significant difference was observed between the two groups. Thus, latanoprost monotherapy is more effective than unfixed combination therapy with 0.5% timolol maleate and 1% dorzolamide in the treatment of CACG following relief of pupillary block in Japanese patients.

Topics: Aged; Antihypertensive Agents; Chronic Disease; Drug Combinations; Female; Glaucoma, Angle-Closure; Humans; Instillation, Drug; Intraocular Pressure; Japan; Latanoprost; Male; Ophthalmic Solutions; Patient Compliance; Prostaglandins F, Synthetic; Sulfonamides; Thiophenes; Timolol

To characterize and compare the ocular comfort and symptoms of dorzolamide and tear-replacement drops (placebo) in healthy volunteers.. Subjects were randomized in a double-masked fashion to receive each medicine for 6 days twice daily. Patients used a visual analog scale to assess the quality and intensity of pain temporally after initial (acute) dosing and after 6 days of chronic dosing. The visual analog scale, an objective measure of pain, allows a subject to grade their perceived intensity of pain on a line between 0 and 100 mm.. Of 28 subjects enrolled in the study, 27 completed the protocol (1 subject was lost to follow-up). Dorzolamide demonstrated statistically greater peak ocular pain (21.4 +/- 22.3 mm) compared with placebo (1.9 +/- 4.4 mm) (P<0.0001) after chronic dosing. Time of mean peak pain for dorzolamide products was 15 seconds after dosing. The pain was statistically greater with dorzolamide compared with placebo for 50 seconds after dosing. On average the discomfort associated with dorzolamide lasted 38.9 +/- 17.9 seconds after dosing. The average pain per second for the first minute was 7.1 +/- 10.1 mm for dorzolamide. No differences in pain intensity were observed after acute and chronic dosing. The discomfort with dorzolamide was characterized after chronic dosing as "burning" (14.8 +/- 25.0 mm) and was associated with tearing (1.9 +/- 5.2 mm).. Dorzolamide caused more ocular pain after instillation than placebo. However, the pain was characterized as mild and quickly resolved.

Topics: Acute Disease; Adult; Carbonic Anhydrase Inhibitors; Chronic Disease; Double-Blind Method; Eye Diseases; Female; Humans; Male; Ophthalmic Solutions; Pain; Pain Measurement; Sulfonamides; Thiophenes; Time Factors

The aim of this study is to evaluate the ocular hypotensive efficacy of a topical carbonic anhydrase inhibitor (dorzolamide) in primary open-angle glaucoma patients, administered alone or in association with beta-blockers or with beta-blockers and miotics, in a one-year follow-up.

Topics: Administration, Topical; Adrenergic beta-Antagonists; Carbonic Anhydrase Inhibitors; Chronic Disease; Drug Therapy, Combination; Female; Follow-Up Studies; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Miotics; Pilocarpine; Sulfonamides; Thiophenes; Timolol; Treatment Outcome

To compare the effectiveness of topical dorzolamide hydrochloride (Trusopt, Merck and Co., Inc., West Point, PA), a carbonic anhydrase inhibitor, with that of oral acetazolamide (Diamox; Lederle Laboratories, Pearl River, NY) for the management of chronic cystoid macular edema in patients with retinitis pigmentosa.. A prospective, double-masked, crossover study was conducted in five patients with retinitis pigmentosa who had chronic cystoid macular edema. After baseline visual acuity was measured and a fluorescein angiogram was obtained, each patient was randomly assigned to receive either topical dorzolamide or a placebo for 4 weeks, followed by a crossover for the same period. Oral acetazolamide then was given separately to each patient for 2 weeks. Each phase of the study was followed by a washout period of 4 weeks, during which the patient was taken off all medications. At each visit, best corrected visual acuity was measured, a fluorescein angiogram was obtained, a subjective assessment of the effects on visual function, and any side effects of the medication or placebo were recorded in the form of a questionnaire by an independent observer.. Compared with baseline or placebo values, there was no measurable improvement in visual acuity on the Early Treatment Diabetic Retinopathy Study charts with dorzolamide in any of the patients. The visual acuity in three of five patients, however, improved by seven letters or more with acetazolamide. Compared again with baseline or placebo values, fluorescein angiograms of two of five patients showed improvement in macular edema in both eyes with the use of dorzolamide, whereas all five showed improvement with acetazolamide. The improvement in macular edema was more marked with acetazolamide than with dorzolamide. The effect of dorzolamide given three times a day was the same as that when it was given five times a day. One patient indicated that dorzolamide was more effective than acetazolamide in improving visual function, three of five patients believed that acetazolamide was more effective, and one felt that both were equally effective.. Dorzolamide provided improvement in cases of macular edema on fluorescein angiograms and subjective improvement of visual function in some patients with retinitis pigmentosa with cystoid macular edema. However, there was no measurable improvement in visual acuity with the topical use of this drug. Oral acetazolamide was found to be more effective than dorzolamide in managing macular edema and improving visual acuity.

Topics: Acetazolamide; Administration, Oral; Administration, Topical; Adolescent; Adult; Aged; Carbonic Anhydrase Inhibitors; Chronic Disease; Cross-Over Studies; Double-Blind Method; Female; Fluorescein Angiography; Follow-Up Studies; Fundus Oculi; Humans; Macular Edema; Male; Middle Aged; Ophthalmic Solutions; Prospective Studies; Retinitis Pigmentosa; Sulfonamides; Thiophenes; Visual Acuity

Topics: Acetazolamide; Administration, Oral; Aged; Aged, 80 and over; Carbonic Anhydrase Inhibitors; Chronic Disease; Cross-Over Studies; Double-Blind Method; Female; Follow-Up Studies; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Ophthalmic Solutions; Sulfonamides; Thiophenes; Treatment Outcome

Hypotony with choroidal detachment is a rare complication of glaucoma medication. In this study, we report on a case which supports the hypothesis that has been proposed to explain this phenomenon.. This study was designed as an observational case report.. A woman with chronic glaucoma underwent trabeculectomy on both eyes. Low intraocular pressure (IOP) developed in 1 eye only, with no visual change for many years. After cataract surgery, the IOP increased, necessitating treatment with topical timolol 0.5% and dorzolamide 2%. She developed monocular hypotony and choroidal detachment 3 months later. This complication occurred in the eye that had previously had a low IOP and resolved completely when topical medication was stopped. The choroidal detachment recurred when rechallenged with the same medication.. Topical aqueous suppression therapy can result in hypotony and choroidal detachment in an eye in which relatively low IOP has been maintained for many years after glaucoma filtration surgery. The problem resolves on stopping the medication.

Topics: Adrenergic beta-Antagonists; Antihypertensive Agents; Carbonic Anhydrase Inhibitors; Cataract Extraction; Choroid Diseases; Chronic Disease; Drug Interactions; Drug Therapy, Combination; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Middle Aged; Ocular Hypotension; Ophthalmic Solutions; Prostaglandins F, Synthetic; Recurrence; Sulfonamides; Thiophenes; Timolol; Trabeculectomy

Dorzolamide (Trusopt) is the first topical carbonic anhydrase inhibitor (CAI) that is in clinical use in glaucoma therapy. It is known that CAI have a negative effect on corneal endothelial pumpfunction and therefore on the whole corneal physiology.. 20 patients with open angle glaucoma or ocular hypertension and an elevated intraocular pressure (IOP) over 21 mmHg and without prior oral CAI-treatment were included in this study. Trusopt was administered t.i.d. as monotherapy and b.i.d. in combination with other topical antiglaucoma drugs. Corneal ultrasound pachymetry, corneal endothelial cell count and aesthesiometry were performed prestudy and on days 1, 8, 15, 30, 60 and 90.. Mean corneal thickness was slightly increased on day one (statistically non-significant) and returned to baseline measurements at the following visits, no changes in endothelial cell count and corneal anesthesia were found. Topical dorzolamide is not associated with clinically meaningful changes of the cornea.

Topics: Administration, Topical; Aged; Carbonic Anhydrase Inhibitors; Cell Count; Chronic Disease; Cornea; Drug Therapy, Combination; Endothelium, Corneal; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Ocular Hypertension; Ophthalmic Solutions; Pilocarpine; Sensation; Sulfonamides; Thiophenes; Timolol

Seven patients with open angle glaucoma were treated using Dorsolamida twice daily together Betablocant treat. Five patients with secondary glaucoma were treated with Dorsolamida three time daily as well three patients with edematous postimplant keratopathy. Intraocular pressure decreased with an average of 3-4 mm Hg and at the patients with corneal edema that decreased.

Topics: Administration, Topical; Adrenergic beta-Antagonists; Carbonic Anhydrase Inhibitors; Chronic Disease; Combined Modality Therapy; Corneal Edema; Drug Evaluation; Drug Therapy, Combination; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Sulfonamides; Thiophenes; Time Factors