Effect of Sodium Naproxen on Inflammatory Response Induced by Anterior Chamber Paracentesis in the Rabbit

Abstract

This study evaluated the effect of sodium naproxen (a reversible competitive inhibitor of cyclo-oxygenase) and phenylephrine (a mydriatic alpha-adrenergic agent) eye drops in maintaining atropine mydriasis in the rabbit after paracentesis. Moreover, to assess the influence of these treatments on vascular and cellular inflammatory responses in the rabbit eye, several biochemical parameters were considered. Anterior chamber paracentesis significantly reduced atropine-induced mydriasis and a parallel elevation of proteins, polymorphonuclear leucocytes (PMNs), prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) levels in the secondary aqueous humour (obtained 120 min later) was observed. A significant increase in PMNs in the aqueous humour and a parallel increase in myeloperoxidase activity, a measure of PMN infiltration, in the iris-ciliary body were detected. Atropine-induced mydriasis was maintained in rabbits treated with either sodium naproxen or phenylephrine eye drops. However, only in the former group were the inflammatory parameters significantly reduced, with the exception of aqueous LTB4 levels. The inhibition of the protein influx in the aqueous humour and of the miosis produced by sodium naproxen can be related to the high drug levels in the aqueous humour that were effective in inhibiting the cyclo-oxygenase pathway of arachidonic acid metabolism, whereas the effects on PMN infiltration appear to be independent of significant release of the potent chemotactic agent LTB4, synthesized via the 5-lipoxygenase pathway.

Topical Ocular Delivery of NSAIDs

“…Topical administration of aqueous naproxen sodium eye drops was found to provide a significant protection against sodium arachidonate-induced rise in aqueous humor PGE 2 , protein and polymorphonuclear leukocytes (80). Naproxen was also found to afford protection in rabbits against inflammatory response induced by anterior chamber paracentesis (81). In a comparative study, naproxen sodium (0.2%, wt/vol) drops were found to be as effective as diclofenac sodium (0.1%, wt/vol) drops in controlling post operative inflammation after uncomplicated cataract surgery (82).…”

Topical Nonsteroidal Anti-Inflammatory Drugs in Uncomplicated Cataract Surgery: Effect of Sodium Naproxen

“…The anti-inflammatory properties of sodium napro x e n w e re also confirmed when given as ophthalmic solution even without concurrent corticosteroid treatment (17)(18)(19). In addition, we have recently demonstrated in two randomized clinical trials the efficacy of such solution in the prevention of surgically induced miosis (20).…”

Topical naproxen sodium for inhibition of miosis during cataract surgery. Prospective, randomized clinical trials

“…6,7 Furthermore, naproxen has been shown to be effective in maintaining mydriasis in a rabbit model. 7 The global safety and local tolerance of naproxen eye drops have also been tested in healthy volunteers and found acceptable after either single or repeated conjunctival administrations. 8 A recent study has also shown that this new ophthalmic solution is as effective as diclofenac sodium in controlling postsurgical inflammation in patients who undergo cataract extraction.…”

“…5 As an ophthalmic solution, it is able to decrease aqueous levels of proteins, polymorphonuclear leukocytes and PGE 2 following experimentally induced inflammation in rabbits. 6,7 In addition, topical sodium naproxen successfully maintains mydriasis induced by atropine following paracentesis in the rabbit eye. 7 Safety and tolerance of 0.2% naproxen ophthalmic solution have been shown in healthy volunteers.…”

“…6,7 In addition, topical sodium naproxen successfully maintains mydriasis induced by atropine following paracentesis in the rabbit eye. 7 Safety and tolerance of 0.2% naproxen ophthalmic solution have been shown in healthy volunteers. 8 This ophthalmic solution is also effective in preventing and controlling ocular inflammation after cataract surgery.…”