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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Dorzolamide is a topical sulfonamide carbonic anhydrase inhibitor that is indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension who are insufficiently responsive to β-blockers. In pharmaceutical products, dorzolamide is employed as dorzolamide hydrochloride (CAS number 130693-82-2, EC number not available, molecular formula C10H17ClN2O4S3) (1).
Medical Therapy for Glaucoma
Published in Neil T. Choplin, Carlo E. Traverso, Atlas of Glaucoma, 2014
Jennifer E. Williamson, Janet B. Serle
Subsequently, in 1998, brinzolamide 1% (Azopt), a second topical CAI, was approved for clinical use. Brinzolamide is similar in efficacy to dorzolamide. These agents are commonly prescribed twice daily due to the poor compliance with t.i.d. dosing. IOP should be evaluated in the afternoon to determine whether t.i.d. dosing would be beneficial in an individual patient. The most common ocular side effects of these two agents differ, however. Because brinzolamide is a suspension, it may cause blurring upon instillation, and the most common ocular side effect with use of dorzolamide is stinging upon instillation due to its acidic pH.
Accident and Emergency
Published in Nagi Giumma Barakat, Get Through, 2006
Acetazolamide is a carbonic anhydrase inhibitor. It inhibits bicarbonate reabsorption in the proximal tubule and may cause hypokalaemia and acidosis. It is used for many conditions, including intracranial hypertension, motion sickness, renal tubular acidosis and glaucoma, and is also used as an anticon-vulsant. Another carbonic anhydrase inhibitor, dorzolamide, is used topically for glaucoma.
MFRP variant results in nanophthalmos, retinitis pigmentosa, variability in foveal avascular zone
Published in Ophthalmic Genetics, 2023
Claire Vanden Heuvel, Breanna Aldred, Tyler Boulter, Rachel Sullivan, James Ver Hoeve, Melanie Schmitt
A recent case report of a 52-year-old MFRP patient demonstrated that a two-month course of topical dorzolamide may be effective in reducing cystoid macular edema and preventing foveoschisis in individuals with MFRP mutations (18). Dorzolamide should be considered in these patients if cystic changes develop. While cystoid macular edema is a common cause of increased retinal thickness in RP, a case study by Dinculescu et al. suggested that Müller cell swelling (potentially due to persistence of tissue that would have moved centrifugally in normal development), rather than cystoid macular edema, may underlie retinal thickness changes in some MFRP patients (19). This possibility, in conjunction with the known phenotypic variability among MFRP patients, makes it unclear whether dorzolamide treatment is indicated in patients without cystic macular changes such as ours.
Systemic side effects of glaucoma medications
Published in Clinical and Experimental Optometry, 2022
Amirmohsen Arbabi, Xuan Bao, Wesam Shamseldin Shalaby, Reza Razeghinejad
Timolol use in pregnancy was associated with foetal bradycardia and cardiac arrhythmia.102 Delayed intrauterine growth was observed with the use of fixed combination timolol–dorzolamide in one of the eight pregnant patients’ case series.103 On the other hand, the rate of low birth weight with topical beta blockers in 189 pregnant patients in a population-based study was 9%, which was similar to that of the matched control group of 1952 women.104 The rates of low birth weight infants with carbonic anhydrase inhibitors, cholinergics, prostaglandin analogs, and brimonidine were 28.6%, 25%, 12.5%, and 10%, respectively, which were higher than that of the control group (6.2%).104 Once-daily topical timolol 0.1% gel forming solution has less systemic absorption than the aqueous solution and may be a safer alternative during pregnancy.105
Association of Ocular Antihypertensive Medications and the Development and Progression of Age-related Macular Degeneration in a U.S. Insurance Claims Database
Published in Current Eye Research, 2021
Emily A. Eton, Thomas J. Wubben, Cagri G. Besirli, Sophia Y. Wang
Carbonic anhydrase inhibitors (CAI) had differing effects on the course of AMD with different administration routes as well as when accounting for duration of therapy. When evaluating progression to exudative AMD, topical carbonic anhydrase inhibitors had adecreased hazard of progression. There was no effect on the development of exudation with oral carbonic anhydrase inhibitors, but this lack of observed association may be secondary to the small number of patients in this sub-group. The decrease in progression to wet AMD seen with topical CAIs may represent adelay in recognizing the conversion to exudative AMD. In arandomized control trial, topical dorzolamide-timolol in combination with continued anti-vascular endothelial growth factor (VEGF) injections has been shown to decrease central macular thickness in patients with persistent exudative AMD,12 with the dorzolamide component of the medication postulated to regulate the pumping of fluid out of the retina by the retinal pigment epithelium.10 Additionally, dorzolamide is commonly used for the treatment of cystoid macular edema in other retinal diseases including retinitis pigmentosa and X-linked retinoschisis.28,29 This previously established retinal drying effect of dorzolamide may mask the detection of early conversion to exudative AMD on examination and explain the decreased hazard of developing exudative AMD in persons exposed to topical CAIs seen in this study.