dorzolamide and Corneal-Diseases

To investigate the effect of dorzolamide hydrochloride on central corneal thickness in humans with cornea guttata.. Randomized, placebo-controlled, double-masked, 2-drug crossover study with 10 patients with cornea guttata and 10 healthy controls, who had mean endothelial cell counts of 988 and 2377 cells/mm(2), respectively. Study medications were 2% dorzolamide and placebo drops applied 3 times a day for 4 weeks. Central corneal thickness measurements using ACMaster (Carl Zeiss Meditec AG, Jena, Germany) and Goldmann applanation tonometry were performed at baseline, 1 day, 1 week, and 4 weeks.. The mean increases in central corneal thickness after 4 weeks in eyes with cornea guttata treated with dorzolamide and placebo were 26.3 microm (95% confidence interval, 8.8 to 43.7) and 3.3 microm (95% confidence interval, -0.5 to 7.1), respectively. No statistically significant changes were measured in the healthy control group. Dorzolamide caused a significant decrease in intraocular pressure (P < .01) while placebo did not cause significant changes (P = .50).. Application of dorzolamide for 4 weeks resulted in a statistically significant increase in central corneal thickness in patients with compromised corneal endothelium. These results indicate that patients with corneal endothelial problems receiving dorzolamide therapy should be monitored.

Topics: Aged; Aged, 80 and over; Body Weights and Measures; Carbonic Anhydrase Inhibitors; Cell Count; Cornea; Corneal Diseases; Corneal Edema; Cross-Over Studies; Double-Blind Method; Endothelium, Corneal; Female; Humans; Interferometry; Intraocular Pressure; Light; Male; Middle Aged; Sulfonamides; Thiophenes; Tonometry, Ocular

To investigate the short-term effect of dorzolamide hydrochloride, a topical carbonic anhydrase inhibitor, on central corneal thickness in patients with cornea guttata.. In this randomized, placebo-controlled, double-masked, 3-drug crossover study, 20 patients with cornea guttata (mean endothelial cell count, 1321 cells/mm2) and 8 healthy control subjects (mean endothelial cell count, 2483 cells/mm2) were included. Study medications included 2% dorzolamide hydrochloride (Trusopt 2% eye drops; Merck & Co Inc, Whitehouse Station, NJ), 0.9% saline solution (saline placebo), and a solution identical to the carrier substance of dorzolamide in Trusopt (carrier placebo). The study drugs were applied 4 times per day for 1 day only. Central corneal thickness measurements were performed using partial coherence interferometry on every study day at baseline and after 24 hours of study medication treatment.. Change in central corneal thickness.. The mean thickening in central corneal thickness within 24 hours in eyes with cornea guttata treated with dorzolamide, saline placebo, and carrier placebo was 12.0 micro m (95% confidence interval [CI], 7.0-17.1 microm), 0.6 micro m (95% CI, -1.0 to 2.2 microm), and 1.3 micro m (95% CI, -0.1 to 2.6 microm), respectively.. Application of dorzolamide for 1 day results in a slight but statistically significant thickening of central corneal thickness in patients with cornea guttata.

Topics: Administration, Topical; Aged; Aged, 80 and over; Carbonic Anhydrase Inhibitors; Cell Count; Cornea; Corneal Diseases; Cross-Over Studies; Double-Blind Method; Endothelium, Corneal; Female; Humans; Hypertrophy; Interferometry; Light; Male; Middle Aged; Sulfonamides; Thiophenes

The purpose of this study was to report a case of acute corneal endothelial decompensation caused by a topical dorzolamide/timolol fixed combination (DTFC) after Descemet stripping automated endothelial keratoplasty.. A 75-year-old woman who was referred to our hospital with a chief complaint of visual disturbance in the right eye after cataract surgery. Anterior segment optical coherence tomography identified an extensive defect in Descemet membrane. The patient subsequently underwent uneventful Descemet stripping automated endothelial keratoplasty surgery for persistent corneal edema. Two weeks after surgery, she had been prescribed topical DTFC twice daily to control elevated intraocular pressure. On the day she started using the eye drops, the patient noticed an acute deterioration of visual acuity. Severe corneal edema was detected at follow-up 5 days later.. The topical DTFC was stopped immediately. Thereafter, the corneal edema improved gradually, and there was a reduction in corneal thickness.. Topical DTFC should be used with caution after corneal endothelial transplantation because of the possibility of iatrogenic corneal endothelial dysfunction.

Topics: Aged; Corneal Diseases; Corneal Edema; Descemet Stripping Endothelial Keratoplasty; Endothelium, Corneal; Female; Humans; Sulfonamides; Thiophenes; Timolol

To report a case of reversible corneal endothelial abnormalities after treatment with netarsudil.. A 68-year-old woman presented with the complaint of blurred vision soon after starting treatment with the fixed-dose combination of netarsudil and latanoprost (FC-netarsudil-latanoprost). She had been receiving the fixed-dose combination of dorzolamide and timolol and latanoprost for primary open-angle glaucoma until her ophthalmologist switched latanoprost to FC-netarsudil-latanoprost 2 months before referral to our center.Best-corrected visual acuity was 20/20-1 in the right eye and 20/20-3 in the left eye. The slit-lamp biomicroscopic examination was remarkable for a guttata-like abnormality of the corneal endothelium of both eyes. The intraocular pressure was 10 mm Hg in both eyes. Specular microscopy revealed irregularly shaped corneal endothelial cells with indistinct borders between cells. FC-netarsudil-latanoprost was replaced with latanoprost in the left eye but continued in the right eye. Nine weeks later, best-corrected visual acuity remained 20/20-1 in the right eye but it improved to 20/20 in the left eye. Repeat specular microscopy was unchanged in the right eye and was normal in the left eye.. Topical therapy with netarsudil can result in guttata-like changes of the corneal endothelium and corneal endothelial cell abnormalities that can be detected with specular microscopy. These abnormalities seem to be transient and resolved upon the cessation of netarsudil. Ophthalmologists should consider the possibility of a corneal endothelial abnormality in patients treated with netarsudil who develop blurred vision.

Topics: Aged; Antihypertensive Agents; Benzoates; beta-Alanine; Corneal Diseases; Drug Therapy, Combination; Endothelium, Corneal; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Remission Induction; Sulfonamides; Thiophenes; Timolol; Tonometry, Ocular; Withholding Treatment

Topics: Administration, Topical; Carbonic Anhydrase Inhibitors; Corneal Diseases; Endothelium, Corneal; Humans; Sulfonamides; Thiophenes

Topics: Acetazolamide; Carbonic Anhydrase Inhibitors; Corneal Diseases; Drug Therapy, Combination; Endothelium, Corneal; Glaucoma; Humans; Intraocular Pressure; Sulfonamides; Thiophenes