Title: Additive Effect of Topical Dorzolamide and Systemic Acetazolamide in Pediatric Glaucoma
Abstract: Introduction: Acetazolamide and dorzolamide 2% were, respectively, the first commercial systemic and topical carbonic anhydrase inhibitors used in glaucoma treatment. There is debate regarding the presence 1 Maus T. Larsson L. Mclaren J. et al. Comparison of dorzolamide and acetazolamide as suppressors of aqueous humor flow in humans. Arch Ophthalmol. 1997; 115: 45-49 Crossref PubMed Scopus (93) Google Scholar or absence 2 Rosenberg L.F. Krupin T. Tang L. et al. Combination of systemic acetazolamide and topical dorzolamide in reducing intraocular pressure and aqueous humor formation. Ophthalmology. 1998; 105: 88-93 Abstract Full Text PDF PubMed Scopus (39) Google Scholar of an additional effect on intraocular pressure (IOP) from adding oral acetazolamide to topical dorzolamide. Method: We are retrospectively studying children with glaucoma diagnosed before 16 years of age. Eyes whose treatment included topical dorzolamide or Cosopt®, followed by addition of oral acetazolamide, were included. Eyes with uveitis or surgical procedures within 3 months prior to acetazolamide therapy are excluded. Data collected include IOP before and after oral acetazolamide commencement and the daily dose of acetazolamide. Results: Aphakic and idiopathic congenital glaucoma were the most common etiological diagnoses. Twenty-one children aged 1 month to 16 years were included in the study. In cases on dorzolamide or Cosopt to both eyes, one eye was randomized and included in the study. The oral acetazolamide dose ranged from 19 to 28 mg/kg/d. Pre-acetazolamide IOP (mean 31, range 28 to 39 mm Hg), post-acetazolamide IOP (mean 19, range 14 to 31 mm Hg), drop in IOP (mean 8, range 4 to 16 mm Hg). Conclusions: Addition of oral acetazolamide led to a significant drop in IOP (Pdespite the presence of topical dorzolamide 2%). Children may have higher intraocular carbonic anhydrase enzyme activity levels, thus explaining the noticeable additive effect observed.
Publication Year: 2006
Publication Date: 2006-02-01
Language: en
Type: article
Indexed In: ['crossref']
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Cited By Count: 2
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