dorzolamide and Glaucoma--Angle-Closure

Almost five years have elapsed since the introduction of latanoprost on several markets and considering the large number of publications dealing with it, the authors felt that it was worth re-evaluating the drug.. The criterion used to select trials for inclusion in the review was: all articles mentioning the drug in common electronic data-bases; these were then screened and considered, on the basis of methodological quality.. Experimental data suggest that latanoprost acts by remodeling the extracellular matrix in the ciliary muscle, thus increasing the flow of aqueous humor through the ciliary muscle bundles of the uveoscleral pathway. POAG: Latanoprost persistently improves the pulsatile ocular blood flow in primary open angle glaucoma (POAG). Recent trials confirmed the greater IOP-lowering efficacy of latanoprost vs. timolol, dorzolamide, brimonidine and unoprostone. Trials lasting up to 24 months showed that latanoprost is effective in long-term treatment of POAG and ocular hypertension (OH), with no signs of loss of efficacy when compared to timolol or dorzolamide. Latanoprost provides better control of circadian IOP. Non-responders to beta-blockers should preferably be switched to latanoprost monotherapy before a combination therapy is started. The possibility of a fixed combination of latanoprost and timolol has been explored, with promising results. NTG: Latanoprost is effective in normal tension glaucoma (NTG), lowering IOP, improving pulsatile ocular blood flow and increasing ocular perfusion pressure. OTHER GLAUCOMAS: Latanoprost may provide effective IOP control in angle-closure glaucoma after iridectomy, in pigmentary glaucoma, glaucoma after cataract extraction and steroid-induced glaucoma. However, latanoprost was effective in only a minority of pediatric cases of glaucoma and is contraindicated in all forms of uveitic glaucoma.. In the articles reviewed, new or duration-related adverse events were reported.

Topics: Antihypertensive Agents; Aqueous Humor; Blood Flow Velocity; Circadian Rhythm; Clinical Trials as Topic; Drug Therapy, Combination; Eye; Glaucoma, Angle-Closure; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Ocular Hypertension; Prostaglandins F, Synthetic; Safety; Sulfonamides; Thiophenes; Timolol

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 report and describe the management a rare case of transient bilateral angle closure with increased intraocular pressure (IOP) and myopic shift while on isotretinoin therapy for acne.. A 28-year-old woman presented with bilateral myopic shift, angle closure with IOP increase, and supraciliary effusion 1 week after acne therapy with isotretinoin. Two weeks after stopping isotretinoin, and treatment with topical prednisolone acetate, atropine, and fixed combination of timolol and dorzolamide, refraction, IOP returned to normal and supraciliary effusions was decreased on ultrasound biomicroscopy.. Oral isotretinoin for acne treatment may be associated with an adverse reaction, resulting in bilateral transient myopia and angle closure with IOP elevation.

Topics: Acne Vulgaris; Adult; Antihypertensive Agents; Dermatologic Agents; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Isotretinoin; Microscopy, Acoustic; Myopia; Sulfonamides; Thiophenes; Timolol

To determine the effect of 1% brinzolamide, 2% dorzolamide hydrochloride or combination 2% dorzolamide hydrochloride/0 · 5% timolol to delay the elevation of the intraocular pressure in second eyes of dogs with primary closed-angle glaucoma.. Analysis of retrospectively collated data from 40 dogs with primary closed-angle glaucoma, where the non-affected eye was treated prophylactically with brinzolamide (n = 10), dorzolamide (n = 18) or combination dorzolamide/timolol therapy (n = 12).. The 40 treated dogs (median age of 76 · 2 months) comprised 25 females/15 males, 19 entire/21 neutered. Twenty dogs developed glaucoma in the contralateral eye (median time of 9 · 2 months). No statistically significant difference was identified during treatment failure between the treatment groups (P = 0 · 66). The second eye remained normotensive in 20 dogs; four dogs until the conclusion of the study (median: 27 · 0 months), three dogs until death (median: 15 · 4 months), seven dogs until lost to follow-up (median: 11 · 6 months). Out of these 20 dogs, treatment was discontinued because of lack of owner compliance in two dogs and following a local drug reaction in four dogs (median: 8 · 9 months).. There was no evidence that the tested drugs delayed elevation of intraocular pressure in contralateral eyes of dogs with primary closed-angle glaucoma.

Topics: Administration, Ophthalmic; Animals; Carbonic Anhydrase Inhibitors; Dog Diseases; Dogs; Drug Therapy, Combination; Female; Glaucoma, Angle-Closure; Intraocular Pressure; Male; Retrospective Studies; Sulfonamides; Thiazines; Thiophenes; Timolol

To evaluate long-term efficacy of antiglaucoma medications with or without combined topical anti-inflammatory treatment in preventing increased intraocular pressure and clinical signs of glaucoma in eyes considered at risk of the development of the disease.. Retrospective analysis identified 88 canine patients presenting with unilateral acute congestive primary angle-closure glaucoma (IOP > 25 mm Hg) and gonioscopic findings of pectinate ligament dysplasia and/or narrow or closed iridocorneal angle in the contralateral nonglaucomatous eye. Patients with histopathologic confirmation of pectinate ligament dysplasia or angle closure in the initial glaucomatous eye receiving prophylactic medical therapy in the contralateral eye were included. Time to medical failure for each antiglaucoma medication and efficacy of the combination therapy were evaluated.. The most commonly affected pure-breds were the American Cocker Spaniel (20.4%) and Basset Hound (11.36%). The patients receiving demecarium bromide 0.125% had the longest estimated median time to medical failure at 330.0 days, followed by latanoprost 0.005%, dorzolamide hydrochloride 2.0%, and demecarium bromide 0.25% at 284.0 days, 272.5 days, and 143.0 days, respectively. The estimated median time to medical failure for patients receiving topical antiglaucoma and anti-inflammatory medication was 324.0 days versus 195.0 days in patients receiving antiglaucoma medication alone. Survival analysis showed no statistical significance.. None of the four antiglaucoma medications evaluated statistically delayed medical failure when compared to each other. Although significance was not achieved, our data suggest that adjunctive use of topical anti-inflammatory medications may be beneficial in these cases.

Topics: Administration, Topical; Animals; Anti-Inflammatory Agents; Antihypertensive Agents; Carbonic Anhydrase Inhibitors; Cholinesterase Inhibitors; Dog Diseases; Dogs; Female; Glaucoma, Angle-Closure; Intraocular Pressure; Latanoprost; Male; Prostaglandins F, Synthetic; Quaternary Ammonium Compounds; Retrospective Studies; Sulfonamides; Thiophenes

Topics: Acetazolamide; Acute Disease; Anesthesia, General; Atropine; Combined Modality Therapy; Corneal Edema; Dexamethasone; Drug Therapy, Combination; Female; Glaucoma, Angle-Closure; Humans; Laser Therapy; Mannitol; Middle Aged; Mydriasis; Pilocarpine; Postoperative Complications; Sulfonamides; Thiophenes; Timolol; Vomiting

A case of a patient with Weill-Marchesani syndrome who developed a secondary glaucoma due to synechiae in both eyes is described. As intraocular pressure (IOP) could not be controlled with medical treatment in the left eye (LE), the patient underwent glaucoma filtering surgery. IOP was controlled and no complications occurred. However, 15 months later, athalamia stage 1 was diagnosed in the LE, without any alterations in the posterior pole. To solve this complication, a vitrectomy with lens extraction and intraocular lens implantation in the LE was performed. Currently, IOP is 12 mmHg and the anterior chamber remains deep.. The association of vitrectomy and lens surgery in those cases where there is a predisposition to forward movement of the lens, might reduce intra and postoperative complications.

Topics: Abnormalities, Multiple; Adult; Cataract Extraction; Combined Modality Therapy; Drug Resistance; Dwarfism; Female; Fingers; Glaucoma, Angle-Closure; Hand Deformities, Congenital; Humans; Intraocular Pressure; Iridectomy; Lens Implantation, Intraocular; Lens, Crystalline; Mitomycins; Phacoemulsification; Postoperative Complications; Sulfonamides; Syndrome; Thiophenes; Trabeculectomy; Vitrectomy

Topics: Aged; Aged, 80 and over; Carbonic Anhydrase Inhibitors; Conjunctiva; Conjunctivitis; Female; Glaucoma, Angle-Closure; Humans; Male; Ocular Hypertension; Ophthalmic Solutions; Sulfonamides; Thiophenes

Topics: Adrenergic beta-Antagonists; Antihypertensive Agents; Drug Therapy, Combination; Female; Glaucoma, Angle-Closure; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Levobunolol; Macula Lutea; Middle Aged; Ocular Hypotension; Ophthalmic Solutions; Prednisolone; Prodrugs; Pseudophakia; Recurrence; Retinal Diseases; Sulfonamides; Thiophenes; Ultrasonography