Selective α2-agonists in the treatment of glaucoma: pharmacology, efficacy and safety

Kurysheva, N I

doi:10.17116/oftalma2019135021144

Vestn. oftal'mol.

2019

DOI: 10.17116/oftalma2019135021144

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Selective α2-agonists in the treatment of glaucoma: pharmacology, efficacy and safety

N I Kurysheva¹

Abstract: Glaucoma is the main cause of irreversible blindness in the world. Among the hypotensive eye drops, an important place belongs to the selective α2-adrenergic receptor antagonist brimonidine. This part of the review focuses on key pharmacological and therapeutic characteristics of brimonidine and its mode of action. The article also discusses the side effects of brimonidine and the methods of their prevention.

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Cited by 3 publications

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“…Approximately 80% of the information received by a person comes from visual perception. Most ophthalmic diseases are caused by fundus retinopathy [2], and the colour fundus image is the one crucial tool that can capture the human microvascular network directly and non-invasively. Doctors can judge the severity of related diseases by observing the structural characteristics of the retinal This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.…”

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confidence: 99%

Feature pyramid U‐Net for retinal vessel segmentation

Liu

Xue

et al. 2021

IET Image Processing

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The retinal vessel is the only microvascular network that can be directly and non-invasively observed in humans. Cardiovascular and cerebrovascular diseases, such as diabetes, hypertension, can lead to structural changes of the retinal microvascular network. Therefore, it is of great significance to study effective retinal vessel segmentation methods and assist doctors in early diagnoses with quantitative results for vascular networks. In this study, we propose a novel convolutional neural network named feature pyramid U-Net (FPU-Net) that extracts multiscale representations by constructing two feature pyramids both on the encoder and the decoder of U-Net. In this representation, objects features with different size like micro-vessels and pathology will be fused for better vessel segmentation. The experimental results show that compared with state-of-the-art methods, FPU-Net is superior in terms of accuracy, sensitivity, F1-score, and area under the curve and capable of stronger domain generalisation across different datasets. INTRODUCTIONMedical image analysis is essential to diagnose the various types of diseases. Segmentation is an important step in many medical applications involving measurements, registration, visualisation, and computer-aided diagnosis (CAD). To help clinicians make an accurate diagnosis, it is necessary to segment some crucial objects in medical images and extract features from segmented areas to make anatomical or pathological structures changes more clear in images and play a pivotal role in CAD on account of the improvement in diagnostic efficiency and accuracy [1].The eye is one of the most important organs through which human receives external information. Approximately 80% of the information received by a person comes from visual perception. Most ophthalmic diseases are caused by fundus retinopathy [2], and the colour fundus image is the one crucial tool that can capture the human microvascular network directly and non-invasively. Doctors can judge the severity of related diseases by observing the structural characteristics of the retinal This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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mentioning

confidence: 99%

Feature pyramid U‐Net for retinal vessel segmentation

Liu

Xue

et al. 2021

IET Image Processing

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Normal-Tension Glaucoma: Epidemiology, Pathogenesis, Diagnosis and Treatment. Literature Review. Part 2. Role of Vascular Dysregulation in the Pathogenesis. Treatment of Normal Tension Glaucoma

Kurysheva,

Kim,

Plieva

et al. 2023

Oftalʹmologiâ

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Insufficient blood supply, vascular dysregulation, perfusion pressure and endothelial dysfunction may account for the pathogenic mechanism. OCT angiography (OCTA) measurements have been reported to be useful for glaucoma diagnostics. OCTA microvasculature could serve as a potential biomarker for glaucoma diagnosis. One of the important criteria for the treatment of NTG is the reduction of IOP, which is achieved by both conservative methods of treatment and laser and surgical interventions. With timely diagnosis, control of IOP and monitoring of morphofunctional changes in the eyes with NTG, it becomes possible to suspend the development of glaucoma optic neuropathy and preserve the patient’s vision for a long time.

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Comparative Evaluation of the Efficacy and Safety of Brimonidine Generics in Glaucoma Therapy

Antonov,

Vitkov,

Kozlova

et al. 2023

Oftalʹmologiâ

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Glaucoma is a chronic neurodegenerative disease that eventually leads to irreversible blindness. The main risk factor for the development and progression of glaucoma is elevated IOP. In cases where the use of prostaglandin analogues is limited, brimonidine is the most rational choice as initial therapy. It is the only molecule that both reduces aqueous humor production and enhances uveoscleral outflow. The use of several hypotensive drugs for a long time can lead to pronounced changes in the tissues of the anterior segment of the eye. In this case, there are complaints characteristic of the dry eye syndrome. The aggravation of this condition can affect the adherence of patients to treatment and worsen the course of the disease. Therefore, it is important to prescribe hypotensive drugs that have a sufficient hypotensive effect with a good safety profile. Purpose. To evaluate the efficacy and safety of Brimonidine SZ in combination therapy for glaucoma after changing the hypotensive regimen. Patients and methods. The study was conducted in a group of 50 patients (50 eyes) with initial or advanced drug-compensated primary open-angle glaucoma (mean age 64.8 years), among them there were 27 (54 %) women and 23 (46 %) men. In patients included in the study, brimonidine 0.15 % or 0.2 % was replaced with Brimonidine SZ as part of combination hypotensive therapy. To analyze the results obtained, data on corneal-compensated IOP, the degree of corneal staining with fluorescein, assessments of conjunctival hyperemia, indicators of the OSDI questionnaire and the level of adherence to treatment at the initial visit, as well as 1 and 3 months after changing the hypotensive regimen, were compared. Results. There were no statistically significant differences in the level of IOP at different times after changing the hypotensive regimen. Objective indicators of the state of the tissues of the anterior surface of the eye did not change. According to the results of the evaluation of the main signs of dry eye syndrome (OSDI) and the degree of adherence of patients to treatment, no significant changes were found either. Conclusion. Brimonidine SZ has a similar hypotensive efficacy with brimonidine 0.15 % and 0.2 % as part of combination hypotensive therapy. The safety profile of Brimonidine SZ is comparable to analogues, which allows us to consider this drug as a possible alternative when choosing hypotensive therapy.

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Selective α2-agonists in the treatment of glaucoma: pharmacology, efficacy and safety

Cited by 3 publications

References 57 publications

Feature pyramid U‐Net for retinal vessel segmentation

Feature pyramid U‐Net for retinal vessel segmentation

Normal-Tension Glaucoma: Epidemiology, Pathogenesis, Diagnosis and Treatment. Literature Review. Part 2. Role of Vascular Dysregulation in the Pathogenesis. Treatment of Normal Tension Glaucoma

Comparative Evaluation of the Efficacy and Safety of Brimonidine Generics in Glaucoma Therapy

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