Update on topical carbonic anhydrase inhibitors

Abstract

Topical carbonic anhydrase inhibitors are a novel addition to the armamentarium of medical glaucoma treatment; dorzolamide has been available since 1995 and brinzolamide since 1998. They lower intraocular pressure by inhibiting carbonic anhydrase, a key enzyme for aqueous humor formation. Intraocular pressure-lowering activity of the substances appears to be the same and is similar to that of most other agents, but it does not reach the activity of the unselective beta-blocker timolol or the prostaglandin latanoprost. On concomitant treatment, additivity is reached with all other topical agents. A possible improvement of blood flow may offer an additional benefit, but its significance for the long-term outcome for human glaucoma remains to be shown. Side effects are mostly local. A more physiologic pH of brinzolamide appears to be advantageous.

Side effects of commonly used glaucoma medications: comparison of tolerability, chance of discontinuation, and patient satisfaction

“…These medications were timolol, latanoprost, the fixed combination of latanoprost and timolol (Xalcom®) and the fixed combination of dorzolamide and timolol (Cosopt®). These results corroborate published review studies on glaucoma medication [5][6][7][8][9][10][11][12][13].…”

Toxic Epidermal Necrolysis Induced by the Topical Carbonic Anhydrase Inhibitors Brinzolamide and Dorzolamide

“…Brinzolamide and dorzolamide are highly specific topical CAIs, which lower intraocular pressure 2,3 . Therefore, topical application of intraopthalmic CAIs is recommended to control intraocular pressure, as this route of administration lowers ocular hypertension without serious adverse reactions.…”

The Efficacy and Safety of Topical Brinzolamide and Dorzolamide When Added to the Combination Therapy of Latanoprost and a Beta-Blocker in Patients with Glaucoma

“…1 The intraocular pressure (IOP)-lowering effect of brinzolamide 1% is reported to be equivalent to dorzolamide 2% in the monotherapy 2,3 and combination therapy with timolol 0.5%. 4 Furthermore, it is reported that the switching from dorzolamide 2% to brinzolamide 1% resulted in a significant decrease in IOP.…”