Chapter 31: Adrenergic Stimulators

Elhusseiny Abdelrahman M, Alzein Ahmad F, Medeiros Felipe A

Topical carbonic anhydrase inhibitors for glaucoma were linked to increased risk of new-onset depression, antidepressant use, and anxiety. Clinicians should monitor for these neuropsychiatric side effects.

Fan Xin, Harding Phillip A, Ziaei Parissa et al.

A novel gel/microsphere eyedrop for glaucoma drugs showed sustained ocular delivery for 27 days, lower systemic exposure, and potential for improved patient compliance compared to traditional drops.

Dvoriashyna Mariia, Foss Alexander J E, Gaffney Eamonn A et al.

A mathematical model predicted aqueous humor production and composition, identifying key ion channels and transporters (e.g., K+, Cl-, Na+/H+, Na+/K+/2Cl-, carbonic anhydrase) as targets for manipulating outflow and glaucoma treatment.

Kazemi Arash, McLaren Jay W, Sit Arthur J

Topical phenylephrine's effect on episcleral venous pressure (EVP) and intraocular pressure (IOP) was studied. While IOP increased, EVP decreased, indicating IOP elevation isn't due to increased EVP, a clinically relevant finding for glaucoma management.

Stoner Ari, Harris Alon, Oddone Francesco et al.

This review examined topical CAIs for glaucoma, finding they remain valuable combination therapy, potentially influencing ocular hemodynamics beyond pressure reduction, despite less frequent primary use.

Tsujinaka Aika, Takai Yasuyuki, Inoue Yoshitsugu et al.

Weinreb Robert N, Bacharach Jason, Fechtner Robert D et al.

A study found fixed-combination brinzolamide/brimonidine significantly lowered 24-hour intraocular pressure in glaucoma/ocular hypertension patients, offering effective, sustained IOP control.

Mathew David J, Greene Rana A, Mahsood Yousaf J et al.

Preoperative brimonidine 0.2% did not prevent significant, sustained intraocular pressure increases during prostatectomy in steep Trendelenburg, indicating limited protective effect for glaucoma patients in this surgical position.

Sheils Catherine R, Fischer William S, Hollar Rachel A et al.

This study found the Frisén score doesn't consistently reflect papilledema changes (area/volume) after acetazolamide treatment in IIH. Clinicians should use caution relying solely on Frisén for monitoring treatment response.

Makri Olga E, Plotas Panagiotis, Tsapardoni Foteini N et al.

Kupersmith Mark J, Sibony Patrick A, Feldon Steven E et al.

Acetazolamide treatment for IIH significantly reduced retinal and choroidal folds, but not creases, reflecting biodynamic changes. Persistent folds despite swelling reduction suggest permanent tissue alterations.

Rook Brita S, Phillips Paul H

This review highlights pediatric PTC differences from adults, noting revised diagnostic criteria (CSF >28cm H2O) and risk factors like obesity, guiding improved diagnosis and treatment strategies.

Wall Michael, Johnson Chris A, Cello Kimberly E et al.

The IIHTT found acetazolamide significantly improved visual fields in IIH, particularly nasally and around the blind spot, likely due to papilledema reduction, offering clinical benefit.

Schrems Wolfgang A, Schrems-Hoesl Laura M, Mardin Christian Y et al.

Long-term glaucoma drugs, especially prostaglandins (alone or combined), can significantly decrease central corneal thickness. This necessitates regular CCT measurements to avoid underestimating intraocular pressure.

Chandra Saurav, Muir Eric R, Deo Kaiwalya et al.

Dorzolamide lowered IOP and increased retinal/choroidal blood flow in older glaucoma mice, suggesting it may offer both pressure reduction and improved ocular perfusion clinically.

Acetazolamide and weight loss effectively reduce papilledema-related optic nerve swelling in IIH patients, as measured by OCT, offering objective treatment monitoring for this condition.

Tanna Angelo P, Lin Albert B

After PGAs, adding alpha2 agonists, beta blockers, or CAIs similarly lowers diurnal IOP, but side effects and nocturnal/trough efficacy vary. Laser trabeculoplasty is also effective.

Shah Aparna A, Modi Yasha, Thomas Benjamin et al.

Brimonidine eye drops can cause allergic reactions mimicking vernal keratoconjunctivitis, highlighting the need to differentiate drug allergy from underlying ocular surface disease for effective treatment.

Realini T, Nguyen Q H, Katz G et al.

Pooled data showed fixed-combination brinzolamide/brimonidine significantly lowered intraocular pressure more than its individual components in glaucoma/ocular hypertension patients, offering superior efficacy with a consistent safety profile.