Adverse Events and Intraocular Pressure-Lowering Effect of Topical 0.5% Apraclonidine in Childhood Glaucoma: A Retrospective Single-Center Study.

PURPOSE

To evaluate the adverse events and intraocular pressure (IOP)-lowering effects of topical apraclonidine in childhood glaucoma management.

DESIGN

A retrospective case series.

PARTICIPANTS

Glaucoma patients aged <18 years who had received topical apraclonidine

METHODS

We extracted data on demographics, ocular and systemic adverse events, and IOP reduction. We defined and classified childhood glaucoma based on the Childhood Glaucoma Research Network criteria.

MAIN OUTCOMES MEASURES

Adverse events and IOP-lowering effect of topical 0.5% apraclonidine.

RESULTS

We included 108 eyes (90 patients). Glaucoma associated with non-acquired systemic disease or syndrome (36 eyes, 33.3%) was the most common diagnosis, followed by glaucoma following cataract surgery (29 eyes, 26.9%). The median age at glaucoma diagnosis was 32 months (Interquartile Range [IQR]: 5.3-68.5 months). The median age at the start of apraclonidine was 5 years (IQR = 3-9). The mean number of glaucoma medications on apraclonidine initiation was 2.7±0.8. The median duration for apraclonidine use was 327 days (IQR = 42-665). There were no local adverse events reported, and only two cases of systemic adverse events (one case (1.1%) of night terror and one case (1.1%) of somnolence). The mean IOPs were 30±4.6 mmHg (n = 85 eyes) and 24.9±4 mmHg (n = 20 eyes) at baseline and 6 months after use, respectively.

CONCLUSION

Topical apraclonidine use demonstrated a low rate of reported adverse events and was associated with clinically meaningful IOP reduction as an adjunctive treatment in childhood glaucoma.