Use Of Dorzolamide Research Articles

Развитие хориоидальной эффузии на фоне применения ингибиторов карбоангидразы

Relevance. Choroidal effusion is a complication accompanying both surgical interventions and ophthalmopathies of predominantly inflammatory etiology. The release of proteins from choriocapillaries lumen and decrease of intraocular pressure relative to the pressure in the episcleral veins lead to the choroid detachment. Purpose. To analyze the causal link between choroidal effusion and topical application of carbonic anhydrase inhibitors using a clinical example. Material and methods. The paper describes a clinical case of the development of unilateral recurrent choroidal effusion 13 years after sinus trabeculectomy associated with the use of carbonic anhydrase inhibitors. The first episode of choroidal effusion was induced by a fixed combination of brinzolamide with timolol, while the use of dorzolamide caused the repeated episode. The clinical picture was accompanied by significant decrease in visual acuity related to acute hypotension and severe folds of the descemet's membrane. Ultrasonic B-scanning revealed the choroid detachment. The dechallenge of carbonic anhydrase inhibitors, the use of anti-inflammatory and cycloplegic drugs contributed to achieve the choroid adherence. Results. This clinical case clearly demonstrates a causal link between choroidal effusion and topical application of carbonic anhydrase inhibitors. The timely drug therapy made it possible to avoid surgical intervention. Intraocular pressure increased later. Brimonidine was prescribed to reduce it, the intraocular pressure was normalized, and the clinical picture stabilized. Conclusion. Ciliochoroidal effusion may occur in the eyes with primary angle-closure glaucoma even several years after surgical treatment in the setting of the use of this group of hypotensive drugs. It is necessary to take a balanced approach to the use of carbonic anhydrase inhibitors in each particular case, including in primary angle-closure glaucoma. Key words: choroidal effusion, glaucoma, carbonic anhydrase inhibitors, fixed combinations, brimonidine, ophthalmic hypotension.

Dorzolamide as an Effective Topical Therapy for Glaucoma in a Case of Nanophthalmos.

To report a case of nanophthalmos in which the intraocular pressure (IOP) off medication was 45 mm Hg and on dorzolamide hydrochloride once daily was 15 mm Hg for many years. No other medication affected the IOP. A chart review of a patient with nanophthalmos and glaucoma. A case of angle closure glaucoma in a nanophthalmic eye which had an unusually great and prolonged reduction of IOP secondary to the use of dorzolamide once daily, was reported.

Relation of Response to Treatment with Dorzolamide in X-Linked Retinoschisis to the Mechanism of Functional Loss in Retinoschisin

To determine if a positive response of macular cysts to treatment with dorzolamide eye drops in patients with juvenile X-linked retinoschisis (XLRS) can occur with mutations that result in different types of retinoschisin protein dysfunction. Retrospective case series. Thirteen eyes of seven patients seen at the University of Illinois at Chicago with a known diagnosis of XLRS were included. Each patient had received or currently was receiving treatment with topical dorzolamide. One patient from each family was screened for a genetic mutation. Using the method of cell transfection and protein preparation, the mutation in each patient was analyzed further and was categorized into one of three groups: 1) total absence of retinoschisin protein secretion, 2) decreased expression of the secreted protein, or 3) secretion of a nonfunctional protein. The response to dorzolamide was observed using optical coherence tomography. Significant improvement in the foveal zone thickness was observed with the use of dorzolamide in three of four patients with absence of protein secretion, in two patients with a lack of protein expression, and in one patient with a nonfunctional protein secretion. This study showed that the response of macular cysts to dorzolamide in patients with XLRS may be observed independent of the mechanism responsible for retinoschisin protein dysfunction. Hence, treatment with dorzolamide may be effective in patients with different mechanisms of dysfunction in retinoschisin.

Use of topical dorzolamide for patients with X-linked juvenile retinoschisis: case report

X-linked juvenile retinoschisis (XLRS) is a recessively inherited vitreoretinal degeneration characterized by macular pathology and splitting of the neuroretinal layers that is associated with alterations in the XLRS1 gene. There have been no therapeutic interventions known to be effective for patients with X-linked juvenile retinoschisis, but some studies are trying to determine the importance of dorzolamide for the treatment of foveal lesions in this disease. The authors, using optical coherence tomography, describe findings in a patient with X-linked juvenile retinoschisis, before and after a topical use of dorzolamide. Besides the improvement in his visual acuity, further studies are required to elucidate the real prevalence of nonresponse to dorzolamide and the frequency with which there may be a recurrence of foveal cystic changes during continued treatment.

Dorzolamide and corneal recovery from edema in patients with glaucoma or ocular hypertension

PURPOSE: To investigate whether dorzolamide alters corneal hydration control in patients with glaucoma or ocular hypertension. METHODS: Pachymetry, tonometry, and endothelial cell density were measured by a masked observer in 19 subjects with bilateral glaucoma or ocular hypertension. They were treated with 2% dorzolamide in one eye, and with saline in the other, before wearing contact lenses under patched eyes. Corneal thickness, measured each 30 minutes up to 4.5 hours after contact lens removal, enabled estimation of percentage recovery per hour and time for 95% of corneal thickness recovery for both eyes. Seven patients repeated this test after 1 year of dorzolamide use, and their results were compared with those of the preceding year. RESULTS: After induction of hypoxic corneal edema, there was no significant difference between paired corneas in swelling levels (60.0 ± 11.8 and 59.8 ± 12.9 μm) ( P = .94), time to 95% recovery (440.6 ± 255.8 and 445.4 ± 186.7 minutes) ( P = .93), and percentage recovery per hour (38.1% ± 10.9% and 36.1% ± 9.6%) ( P = .40). Subjects followed up after 1 year of dorzolamide use did not differ significantly in values of endothelial cell density, percentage recovery per hour, or time to 95% recovery from those obtained a year before. One subject developed persistent corneal edema after his stress test in the eye treated with dorzolamide. CONCLUSION: There is no significant difference in the recovery from induced corneal edema after either a short-term or 1-year use of dorzolamide in patients with glaucoma or ocular hypertension with a normal corneal endothelium. One patient had persistent corneal edema after the stress test was performed on the dorzolamide-treated eye.

The Use of Dorzolamide and Pilocarpine as Adjunctive Therapy to Timolol in Patients with Elevated Intraocular Pressure

To report the results of two studies on the use of dorzolamide as adjunctive therapy to timolol in patients with elevated intraocular pressure (IOP). In the larger study, the additive effect of dorzolamide administered twice daily also was compared with 2% pilocarpine. Both studies were parallel, randomized, double-masked, placebo-controlled comparisons. In the pilot study, 32 patients received 0.5% timolol twice daily plus either 2% dorzolamide twice daily or placebo twice daily for 8 days. In the Pilocarpine Comparison Study, 261 patients received 0.5% timolol twice daily plus 0.7% dorzolamide twice daily, 2% dorzolamide twice daily, 2% pilocarpine four times daily, or placebo (twice daily or 4 times daily) for 2 weeks. Patients then entered a 6-month extension period and received 0.5% timolol twice daily plus either 0.7% dorzolamide twice daily, 2% dorzolamide twice daily, or 2% pilocarpine four times daily. In the pilot study, after 8 days, additional mean percent reductions in IOP for 2% dorzolamide and placebo were 17% and 3% at morning trough and 19% and 2% at peak, respectively. In the Pilocarpine Comparison Study, after 6 months, additional mean percent reductions in IOP (morning trough) were 9%, 13%, and 10% for 0.7% dorzolamide, 2% dorzolamide, and 2% pilocarpine, respectively. Patients receiving 2% pilocarpine had the highest rate of discontinuation due to a clinical adverse experience, and the use of dorzolamide was not associated with systemic side effects commonly observed with the use of oral carbonic anhydrase inhibitors. Dorzolamide twice daily was effective and well tolerated by the patients in these studies as adjunctive therapy to timolol. The larger study demonstrated that both concentrations of dorzolamide produce similar IOP-lowering effects to 2% pilocarpine.

A Double-Masked, Randomized 1-Year Study Comparing Dorzolamide (Trusopt), Timolol, and Betaxolol

To investigate the safety profile and efficacy of 2.0% dorzolamide hydrochloride, when administered three times daily for up to 1 year, compared with that of 0.5% timolol maleate and 0.5% betaxolol hydrochloride, each administered twice daily. In addition, the effect of adding dorzolamide to the regimen of patients with inadequate ocular hypotensive efficacy while they were receiving one of the two beta-adrenoceptor antagonists and the effect of adding timolol to the regimen of patients receiving dorzolamide were also evaluated. A double-masked, randomized, parallel comparison. Multinational study at 34 international sites. Five hundred twenty-three patients with open-angle glaucoma or ocular hypertension, 17 to 85 years of age. Patients currently using ocular hypotensive medications were required to undergo a washout. Two percent dorzolamide three times a day, 0.5% timolol (Timoptic, Merck, Whitehouse Station, NJ) twice daily, and 0.5% betaxolol solution (Betoptic, Alcon, Fort Worth, Tex) twice daily. At 1 year, the mean percent reduction in intraocular pressure at peak of 2% dorzolamide, 0.5% timolol, and 0.5% betaxolol was approximately 23%, 25%, and 21%, respectively. At afternoon trough, the mean percent reduction in intraocular pressure was 17%, 20%, and 15% for dorzolamide, timolol, and betaxolol, respectively. The ocular hypotensive efficacy of 2.0% dorzolamide, given three times a day, is comparable with that of 0.5% betaxolol, given twice daily, for up to 1 year. In addition, long-term use of dorzolamide was not associated with clinically meaningful electrolyte disturbances or systemic side effects commonly observed with the use of oral carbonic anhydrase inhibitors.