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

Yıl 2002, Cilt: 7 Sayı: 1, 1 - 5, 26.02.2013

M.l. Alimgil Ö. Benian

Öz

Objective:To evaluate the effect of dorzolamide on the
intraocular pressure (IOP), ocular pulse amplitude
(OPA), systemic blood pressure and pulse rate in open-angle 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 18.9±2.2
mmHg; after 4 weeks and 6 months no statistically
significant change was observed (17.6±2.3 and 17.8±3.2
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 18.4±2.3 to 19.3±1.9 mmHg,
p>0.05) and a decrease in OPA (from 3.7±1.2 to 3.2±0.9
mmHg, p>0.05) after 5 months, although these changes
were not statistically significant. The IOP was stable
during the same period (17.3±2.0 and 17.2±2.6 mmHg,
p>0.05) but the OPA showed a slight, but not significant
increase (2.7±1.1 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.

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

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