Cardiovascular Effects of Topical Glaucoma Therapies in Normal Subjects

Hernández, Héctor Hernández y; Cervantes, R Villagran; Frati, Alberto; Hurtado, R; McDonald, Thomas O.; DeSousa, Bergson

doi:10.3109/15569528309065307

Cited by 23 publications

(5 citation statements)

References 8 publications

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“…However, because of its short duration of action, it is used mainly for the prevention of acute glaucoma produced by laser irradiation (11)(12)(13)(14)(15).…”

Section: Resultsmentioning

confidence: 99%

Effects of Antiglaucoma Drugs on Ocular Blood Flow in Ocular Hypertensive Rabbits

Chiou

Chen²

1993

Journal of Ocular Pharmacology and Therapeutics

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Antiglaucoma drugs were studied systematically on the ocular blood flow in ocular hypertensive rabbits. As expected, pilocarpine, clonidine and acetazolamide were all found to increase the ocular blood flow in the retina and choroid.However, their use in the clinics was much less than the /9-blockers, such as Ltimolol, levobunolol, betaxolol and metipranolol. It was surprising to find that all non-specific and /?]-specific adrenergic blockers decreased the ocular blood flow in ocular hypertensive rabbits. If this finding holds true in human patients, the use of yô-blockers for glaucoma treatment should be reconsidered. Dopamine antagonists, such as droperidol, metoclopramide and loxapine, were found to increase the ocular blood flow. Therefore, they might be able to replace ß-blockers for glaucoma treatment.

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“…However, because of its short duration of action, it is used mainly for the prevention of acute glaucoma produced by laser irradiation (11)(12)(13)(14)(15).…”

Section: Resultsmentioning

confidence: 99%

Effects of Antiglaucoma Drugs on Ocular Blood Flow in Ocular Hypertensive Rabbits

Chiou

Chen²

1993

Journal of Ocular Pharmacology and Therapeutics

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“…However, in a recent study (De Dieuleveult et al 1989) a si@cant fall in heart rate after a single drop of betaxolol was found in healthy volunteers. Excercise tests have shown that timolol decreases heart rate during exercise but betaxolol does not, when administered into the lower cul-desac of the eye (Hernandez et al 1983;Atkins et al 1985;Cervantes et al 1986).…”

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confidence: 99%

Plasma and aqueous humour concentrations and systemic effects of topical betaxolol and timolol in man

Ml¹,

Ali‐Melkkilä

Kaila³

et al. 1993

Acta Ophthalmologica

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Plasma and aqueous humour concentrations and systemic effects of timolol and betaxolol were studied after ocular administration in 45 patients scheduled for extracapsular cataract extraction and intraocular lens implantation. The patients were divided randomly into three groups and received 40 microliters of either 0.5% betaxolol, 0.25% timolol or placebo into the lower cul-de-sacs of both eyes. Blood samples were collected over a period of 4 h and blood pressure and heart rate were monitored during the study. Aqueous humour samples were aspirated at the beginning of the operation. Plasma and aqueous humour concentrations of timolol and betaxolol were analyzed using a sensitive radioreceptor assay. The mean plasma concentrations of betaxolol were lower than those of timolol. The concentration of betaxolol in the aqueous humour was twice as high as the concentration of timolol. Both drugs produced a significant decrease in heart rate. In the timolol group a decrease in heart rate was found 15 min after drug administration, and in the betaxolol group after one hour.

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“…T h e absence of consistently significant effects on pulse and MAP in both the betaxolol and timolol groups in our study is common to some other investigations (Berry et al 1984;Stewart et al 1986;Levy et al 1985), and might reflect some of the cited factors and the relatively short treatment duration. Still other studies (Allen 1984: Cervantes et al 1986Hernandez et al 1983;Atkins et al 1985) also found no change in MAP in either group, but did note a decrease in heart rate which was consistently smaller in magnitude with betaxolol than with timolol. Therefore, despite the apparent cardiovascular safety of topical PI-blockers under these controlled study conditions, they must be used carefully in patients with cardiovascular disease in normal clinical practice (Nelson & Kuritsky 1987;Ball 1987;Orlando 1986;Harris et al 1986).…”

Section: Discussionmentioning

confidence: 69%

“…Although results of clinical studies have consistently documented lesser interference with pulmonary function from selective PI-receptor antagonists (Allen 1984;Schoene et al 1984;Van Buskirk et al 1986;Dunn et al 1985Dunn et al , 1986Cervantes et al 1986), serious pulmonary side effects have occasionally resulted from the use of betaxolol (Nelson & Kuritsky 1986). However, the occurrence of cardiovascular side effects has varied widely between studies (Berry et al 1984;Stewart et al 1986;Levy et al 1985;Morselli et al 1983;Ckrvantes et al 1986;Hernandez et al 1983;Atkins et al 1985;DeSantis & Chandler 1985;Leier et al 1986;Novack 1987), perhaps d u e to the different size and demographic characteristics of the various study populations, prior a n d concurrent ocular and systemic therapy, length of the wash-out period, or general health of the patients. Such factors might modify the effect of study medications on the measured cardiovascular parameters.…”

Section: Discussionmentioning

confidence: 99%

A comparison of betaxolol and timolol in open angle glaucoma and ocular hypertension

Feghali

Kaufman

Radius

et al. 1988

Acta Ophthalmologica

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In a randomized, double-masked study, 41 patients with primary open-angle glaucoma or ocular hypertension were treated with betaxolol 0.5% or timolol 0.5% drops for 26 weeks. The average decrease in intraocular pressure (IOP) over the total study period was significant with both betaxolol (-6.3 mmHg) and timolol (-7.2 mmHg) in patients receiving no adjunctive therapy. There was no difference between betaxolol and timolol with respect to changes from baseline IOP. Significantly decreased mean brachial arterial pressure (MAP) was seen only with timolol, although the difference between the two groups was not significant. Pulse, pupil size, and basal tear secretion were unchanged in both groups. Burning upon instillation of the drops was more frequent with betaxolol.

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Cardiovascular Effects of Topical Glaucoma Therapies in Normal Subjects

Cited by 23 publications

References 8 publications

Effects of Antiglaucoma Drugs on Ocular Blood Flow in Ocular Hypertensive Rabbits

Effects of Antiglaucoma Drugs on Ocular Blood Flow in Ocular Hypertensive Rabbits

Plasma and aqueous humour concentrations and systemic effects of topical betaxolol and timolol in man

A comparison of betaxolol and timolol in open angle glaucoma and ocular hypertension

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