Treatment of Glaucoma Using Minidrops of Clonidine

Petursson, Gissur; Cole, Randy; Hanna, Calvin

doi:10.1001/archopht.1984.01040030958024

Cited by 54 publications

(7 citation statements)

References 4 publications

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“…Ophthalmic timolol can cause symptomatic bradycardia, cardiac conduction disorders, orthostatic hypotension, and syncope and falls, particularly in geriatrics [29], and impairs pulmonary function in asthmatics [30]. Similarly, reducing the size of clonidine eyedrops (from 70 to 15 μl) in glaucomatous volunteers prevented the hypotensive effect that occurred with the larger drops [31]. Because these AEs are dose-dependent, microdosing of these and other ocular medications might reduce the likelihood of developing systemic side effects.…”

Section: Discussionmentioning

confidence: 39%

High-precision piezo-ejection Ocular microdosing: Phase II Study on Local and Systemic Effects of Topical Phenylephrine

Ianchulev

Weinreb²,

Tsai

et al. 2017

Ther. Deliv.

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Aim: Conventional eyedropper-delivered volumes (25-50 μl) exceed the eye's usual tear-film volume (7 μl) and precorneal reservoir capacity, risking overflow and ocular/systemic complications. Piezoelectric high-precision microdosing may circumvent these limitations. Results & methodology: In this masked, nonrandomized, cross-over study, subjects (n = 12) underwent pupil dilation with topical phenylephrine (PE) administered by 32-μl eyedropper (2.5% or 10% formulation) and 8-μl electronic microdosing (10% formulation). Microdosing with PE-10% achieved comparable peak dilation as 10% eyedropper-delivery and superior dilation to 2.5% eyedropper-delivery (p = 0.009) at 75 min. Microdosing significantly reduced 20-min plasma PE levels versus PE10% eyedropper; neither treatment altered heart rate/blood pressure. Eye irritation occurred significantly less frequently with microdosing than PE10% eyedrops. Conclusion: Piezo-ejection PE microdosing achieves comparable biological effect as eyedropper dosing; reduced systemic absorption may decrease risk of systemic side effects.

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Section: Discussionmentioning

confidence: 39%

High-precision piezo-ejection Ocular microdosing: Phase II Study on Local and Systemic Effects of Topical Phenylephrine

Ianchulev

Weinreb²,

Tsai

et al. 2017

Ther. Deliv.

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“…However, studies have shown that the drop in blood pressure is small and not significant clinically (Leydhecker 1974;Harrison 1977;Rozsival 1980). Other studies demonstrated that single dose treatment did not change blood pressure and heart rate significantly (Hodapp 1981), and in others the decrease in blood pressure was found to be caused only by clonidine 0.5%, and not by clonidine 0.25% (Petursson 1984). None of our patients experienced any clinically significant systemic hypotension.…”

Section: Discussionsupporting

confidence: 45%

Prevention of the rise in intraocular pressure following neodymium‐YAG posterior capsulotomy using topical clonidine

Loewenstein

Varssano

Lazar

et al. 1991

Acta Ophthalmologica

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We studied the ability of topical clonidine, an alpha-agonist, to suppress the acute rise in intraocular pressure (IOP) following neodymium-YAG posterior capsulotomy (YPC). In a randomized controlled trial 63 eyes were pretreated with one drop of either 0.25% clonidine or saline 1 h before performing YPC and immediately following the procedure. The greatest IOP rise in the saline treated eyes occurred in the second hour after YPC, when the mean (+/- SD) IOP rose from a baseline pressure of 12.7 +/- 3.2 to 18.7 +/- 10.7 mmHg. In clonidine treated eyes, the IOP fell from a mean of 11.9 +/- 3.4 to 9 +/- 3.3 mmHg 2 h postoperatively. In the saline treated group 9 eyes (27%) developed an IOP rise greater than 10 mmHg. Clonidine proved to be highly effective in preventing the rise in IOP following YPC.

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“…With larger volumn eye drops, more medication passes into the nasolacrimal sac, increasing systemic absorption and the risk of toxicity (Shell 1982;Chrai et al 1973). It has been showed that decreasing the drop volume should not reduce efficacy (File & Patton 1980;Petursson et al 1984;Vocci et al 1992;Craig & Griffiths 1991). The smaller eyedrop volumes provoked less reflex lacrimation and permitted a slower lacrimal turnover than the larger volumes.…”

Section: Discussionmentioning

confidence: 99%

The influence of drop size of cyclopentolate, phenylephrine and tropicamide on pupil dilatation and systemic side effects in infants

Elibol

Alçelik

Yüksel

et al. 1997

Acta Ophthalmologica Scandinavica

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In this prospective study, microdrops (mean drop volume 5.6 microl) and commercially available standard drops (mean drop volume 35.4 microl) of cyclopentolate, phenylephrine and tropicamide's clinical efficacy and systemic side effects were compared. Sixty-one infants requiring diagnostic pupil dilatation were studied for pupillary diameter, systemic blood pressure, heart rate and skin flushing changes related to the instillation of mydriatic drops. Both microdrops and standard drops of the drugs produced significant increase in pupillary diameter compared with the baseline (p<0.01). In cyclopentolate and phenylephrine groups, there was no significant pupillary diameter changes between microdrops and standard drops (p>0.05). Mean blood pressure increased significantly in infants given standard drops. There was no significant change in the group that was given microdrops. In our opinion, reduced volume of mydriatics can prevent possible side effects.

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Treatment of Glaucoma Using Minidrops of Clonidine

Cited by 54 publications

References 4 publications

High-precision piezo-ejection Ocular microdosing: Phase II Study on Local and Systemic Effects of Topical Phenylephrine

High-precision piezo-ejection Ocular microdosing: Phase II Study on Local and Systemic Effects of Topical Phenylephrine

Prevention of the rise in intraocular pressure following neodymium‐YAG posterior capsulotomy using topical clonidine

The influence of drop size of cyclopentolate, phenylephrine and tropicamide on pupil dilatation and systemic side effects in infants

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