PROBLEMS IN THE DIFFERENTIAL DIAGNOSIS OF A DELAYED ALLERGIC REACTION IN THE LOCAL ANTIHYPERTENSIVE TREATMENT OF GLAUCOMA


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

An allergic reaction to brimonidine eye drops can manifest itself months after initiation of treatment. The resulting blepharoconjunctivitis because of a delayed reaction can be regarded as infectious, which leads to unduly antimicrobial therapy and additional deterioration of the ocular surface, more severe subjective and objective symptoms. In addition, the allergy to brimonidine may be accompanied by higher intraocular pressure (IOP), which compromises the optic nerve, especially in the advanced stage of glaucoma. Therefore, it is imperative that the allergic reaction to the drug was regarded as such; brimonidine therapy should be discontinued and IOP be immediately evaluated and corrected with an alternative antihypertensive drug regimen or surgery.

Full Text

Restricted Access

About the authors

I. Shteiner

Regional Medical Center

Email: iishte@yandex.ru
Candidate of Medical Sciences Samara

S. Branchevsky

Regional Medical Center

Candidate of Medical Sciences Samara

References

  1. Национальное руководство по глаукоме: для практикующих врачей. Под ред. Е.А. Егорова, Ю.С. Астахова, В.П. Еричева. Изд. 3-е, испр. и доп. / М.: ГЭОТАР-Медиа, 2015; 456 с.
  2. European Glaucoma Society, Terminology and Guidelines for Glaucoma. 4th ed. / Savona, Italy, 2014; 191 р.
  3. Егоров Е.А. Нежелательные явления гипотензивной терапии глаукомы // Клин. офтальмол. - 2007; 8 (4): 144-7.
  4. Arthur S., Cantor L. Update on the role of alpha-agonists in glaucoma management // Ex. Eye Res. - 2011; 93 (3): 271-83.
  5. Galanopoulos A., Goldberg I. Clinical efficacy and neuroprotective effects of brimonidine in the management of glaucoma and ocular hypertension // Clin. Ophthalmol. - 2009; 3: 117-22.
  6. Loon S., Liew G., Fung A. et al. Meta-analysis of randomized controlled trials comparing timolol with brimonidine in the treatment of glaucoma // Clin. Exp. Ophthalmol. - 2008; 36 (3): 281-9.
  7. Araie M., Yamazaki Y., Sugiyama K. et al. Phase III clinical trial of brimonidine in patients with primary open-angle glaucoma and ocular hypertension-comparison of the effects of brimonidine monotherapy versus timolol monotherapy, or combination brimonidine/prostaglandins therapy versus combination placebo/ prostaglandins therapy // Nihon Ganka Gakkai Zasshi. - 2012; 116 (10): 955-66.
  8. Blondeau P., Rousseau J. Allergic reactions to brimonidine in patients treated for glaucoma // Can. J. Ophthalmol. - 2002; 37: 21-6.
  9. Schuman J. Clinical experience with brimonidine 0.2% and timolol 0.5% in glaucoma and ocular hypertension // Surv. Ophthalmol. - 1996; 41 (1): 27-37.
  10. Melamed S., David R. Ongoing clinical assessment of the safety profile and efficacy of brimonidine compared with timolol: year three results. Brimonidine Study Group II // Clin. Ther. - 2000; 22: 103-11.

Supplementary files

Supplementary Files
Action
1. JATS XML

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies