ISSN 1301 - 0883 / E-ISSN 1309 - 3886
 
 








  The Effect of Dorzolamide on Intraocular Pressure and Ocular Pulse Amplitude: Adjunctive Therapy to Beta-Blockers as a Substitite for Pilocarpine or as a Second-Line Therapeutic Agent in Patients with Open-Angle Glaucoma [Eastern J Med]
Eastern J Med. 2002; 7(1): 1-5

The Effect of Dorzolamide on Intraocular Pressure and Ocular Pulse Amplitude: Adjunctive Therapy to Beta-Blockers as a Substitite for Pilocarpine or as a Second-Line Therapeutic Agent in Patients with Open-Angle Glaucoma

M. L. M.L1, . Benian1

To evaluate the effect of dorzolamide on the intraocular pressure (IOP), ocular pulse amplitude (OPA), systemic blood pressure and pulse rate in openangle 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 enrollled. A randomly selected eye of bilaterally affected patients was included in the observer-blinded and parallel-group study. Baseline data consisted of 4 day-time 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 4 weeks and after 6 months in both groups. Results: In Group 1 the baseline IOP was 18.92.2 mmHg; after 4 weeks and 6 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 mmHg to 18.0 2.0 mmHg after 4 weeks (p<0.05) and to 18.4 1.8 mmHg after 6 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 5 months, although these changes were not statistically significant. The IOP was stable during the same period (17.32.0 and 17.22.6 mmHg, p>0.05) but the OPA showed a slight, but not significant increase (2.71.1 and 3.1 1.5 mmHg, p>0.05) in sixteen patients using nonselective beta-blocker and dorzolamide. Conclusion: Dorzolamide is safe and effective when used with beta-blockers but its interaction with selective and nonselective beta-blockers needs further investigation.

Keywords: Intraocular pressure, ocular pulse amplitude, medical therapy, beta-blocker, dorzolamide, pilocarpine


M. L. M.L, . Benian. The Effect of Dorzolamide on Intraocular Pressure and Ocular Pulse Amplitude: Adjunctive Therapy to Beta-Blockers as a Substitite for Pilocarpine or as a Second-Line Therapeutic Agent in Patients with Open-Angle Glaucoma. Eastern J Med. 2002; 7(1): 1-5


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