TJ-CEO
2016 , Vol 11 , Num 1
Carbonic Anhydrase Inhibitors and Hyperosmotic Agents
Numune Training and Research Hospital, Eye Clinic, Ankara/TURKEY
Carbonic anhydrase inhibitors (CAI) are sulphonamide drugs which lower intraocular pressure (IOP) by decreasing aqueous humor production. Unlike systemically prescribed acetazolamide causing significant side effects in most patients, dorzolamide and brinzolamide delivered for topical use are generally well tolerated except for mild local adverse reactions. There are reports indicating favourable effects of CAI on ocular perfusion. Topical CAI are usually used as second choice or adjunctive drugs in glaucoma treatment. However, their fixed combinations with timolol are frequently ranked among medications of first choice.Hyperosmotic agents are useful in the management of acute IOP elevations as they increase the osmolality of the plasma and produce an osmotic gradient which draw water from the vitreus into the circulation resulting in a rapid IOP decrease. Intravenous administration of 20% mannitol solution is the most prefered treatment of choice. Increased cardiovascular load, electrolyte imbalance and central nervous system complications should be kept in mind, and caution should be appiled in patients with compromised renal function.
Keywords : Carbonic anhydrase inhibitors, hyperosmotic agents