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Intraocular pressure following systemic administration of cannabinoids.

Various cannabinoids have been tested for activity compared to delta 9-THC in reducing intraocular pressure after intravenous administration in rabbits at 0.1 mg or 1 mg/animal. Comparison of l-delta 9-, delta 8-, 11-OH-delta 9- and 11-OH- delta 8-THC indicates that minor configurational changes have only a small influence on activity with regard to induction of a fall in intraocular pressure, although 11-OH-delta 8-THC has increased activity. 8 alpha-OH-, 8 alpha-diOH- and 8 beta-diOH-delta 9-THC have little or no activity but 8 beta-OH-delta 9-THC is as active as delta 9-THC indicating that the hydroxyl group in the beta-position does not influence activity. Modification of the C5H11 alkyl side chain (3'-OH-delta 9-THC) reduced activity to 20% relative to delta 9-THC. Cannabidiol (CBD), cannabichromene, cannabigerol and olivetol had no activity, but 10-OH-CBD had some activity at 2 mg/animal. Cannabinol (CBN) had about half the activity of delta 9-THC and activity was reduced further with 1'-OH-CBN, indicating that side chain modification reduced activity. Neither delta 9-THC, nor cannabigerol, had any effect on intraocular pressure or total outflow facility in the rhesus monkey, suggesting species differences in ocular responses to cannabinoids. Further studies on modification of these compounds is warranted in order to further delineate the structure-activity relationships.

Animals↗

The effect of caffeine on intraocular pressure in glaucoma patients.

The authors investigated the effect of drinking regular coffee on intraocular pressure (IOP) using a single-masked randomized crossover study comparing coffee and herbal tea in 13 glaucoma patients. Intraocular pressure and blood pressure were monitored before ingestion of coffee or tea and at 30, 60, and 90 minutes after ingestion. The mean (+/- standard error of measurement) change in IOP 30, 60, and 90 minutes after ingestion for the coffee drinkers was 0.96 +/- 0.4, 1.38 +/- 0.53, and 1.04 +/- 0.37 mmHg, respectively. The mean change in IOP for the tea drinkers 30, 60, and 90 minutes after ingestion was 0.85 +/- 0.41, 0.23 +/- 0.36, and -0.42 +/- 0.44 mmHg, respectively. There was a statistically significant difference in the change in IOP at 90 minutes when comparing coffee to tea (P = 0.003) and no significant difference for 30 and 60 minutes. Although there was a statistically significant difference in IOP at 90 minutes between coffee and tea drinkers, the change was not clinically significant.

Beverages↗

Effect of timolol on intraocular pressure elevation following argon laser iridotomy.

Argon laser iridotomy was performed in 123 eyes of 83 patients with primary angle-closure glaucoma. Sixty-three eyes received argon laser iridotomies with timolol pretreatment and the other 60 eyes served as controls. There were 43 eyes (71.7%) in the control group and 32 eyes (50.7%) in the timolol-pretreated group, whose intraocular pressure increased significantly over baseline level 2 hours after laser treatment. There was statistical difference in the incidence of intraocular pressure elevation in these two groups. Seven eyes (11.7%) in the control group and 4 eyes (6.2%) in the timolol-pretreated group had intraocular pressure elevation at least 11 mmHg over baseline. Additional 28 patients, who received argon laser iridotomy bilaterally, one eye with timolol pretreatment and the other eye served as a matched control, revealed that eyes which were timolol pretreated had statistically significant less intraocular pressure elevation.

Administration, Topical↗

Immobilization stress induces elevation of intraocular pressure in rabbits.

The aim of this study was to test whether immobilization and intravenous volume load as stressors influence the intraocular pressure in rabbits. Rabbits were immobilized for 1 h in a horizontally placed plastic tube with an internal diameter of 13.2 cm and a length of 33.2 cm. After immobilization, rabbits received rapid intravenous drip infusion of 5% glucose solution, 20 ml/kg of body weight, in 5 min. The intraocular pressure immediately after immobilization (11.2 +/- 3.0 mm Hg; mean and standard deviation) was significantly higher compared to control rabbits without immobilization (9.2 +/- 1.0 mm Hg, Student's t test, p = 0.0462). This difference became significantly larger when volume load was exerted on both groups of rabbits (22.7 +/- 5.6 versus 16.4 +/- 2.2 mm Hg, p = 0.0067). Serum levels of cortisol, adrenaline, and noradrenaline were significantly elevated after immobilization (p = 0.0002, p = 0.0271, p = 0.0296, respectively). Venous pressure of the ear tended to increase in rabbits immediately after immobilization (15.8 +/- 3.1 mm Hg) compared with control rabbits (8.5 +/- 2.3 mm Hg), and the difference became significant when volume load was exerted on both groups of rabbits (20.8 +/- 7.4 versus 9.2 +/- 4.8 mm Hg, p = 0.0211). In conclusion, we clearly demonstrated that physical stress due to immobilization, especially in combination with volume load, increased intraocular pressure in rabbits.

Animals↗

The intraocular pressure and diabetes--a correlative study.

In the present study 60 diabetics were examined for intraocular pressure, scleral rigidity and facility of outflow. The intraocular pressure was found higher than in the general population except in patients with proliferative retinopathy. There was no marked difference in scleral rigidity in diabetics. The facility of outflow was lower in diabetic patients.

Adult↗

Increased intraocular pressure after third ventricle injections of prostaglandin E1 and arachidonic acid.

Prostaglandin E1 administered into the third ventricle of rabbits produced increased intraocular pressure and body temperature. Similar responses were observed after third ventricle instillation of arachidonic acid, a precursor of prostaglandin E2. Increase of body temperature occurred with lower doses of prostaglandin E1 and arachidonic acid while the intraocular pressure response required larger amounts of these drugs. Pretreatment with aspirin rectal suppositories had no effect on the third ventricle responses induced by prostaglandin E1. Aspirin pretreatment before third ventricle instillation of arachidonic acid blocked the increases of intraocular pressure and temperature.

Animals↗

Neurosensory detachment arising from a fractured inner-limiting membrane secondary to chronically elevated intraocular pressure.

UNLABELLED: Diffuse optic nerve excavation and focal rim loss mimicking an optic pit have never been reported to predispose patients to serous detachments despite their relative frequency among patients with glaucoma. Recent reports of idiopathic macular schisis detachments occurring in the setting of elevated intraocular pressure without evidence of a contributing comorbidity have caused some to speculate that alternative mechanisms exist with the capacity to engender these retinal complications. Experimental simian research has unveiled the capacity of chronically elevated intraocular pressure to yield conduction portals between the posterior hyaloid face and the subretinal space by inducing microscopic fractures in the inner-limiting membrane. To our knowledge, this is the first case report providing objective evidence of an idiopathic neurosensory detachment resulting from a fractured inner-limiting membrane arising in the setting of chronically elevated intraocular pressures. CASE REPORT: A 34-year old black man presented with transient eye pain and fluctuating vision in his left eye with his current spectacle prescription. A 2-year history of right eye blindness from glaucoma was uncovered. Funduscopic evaluation revealed a broad neurosensory detachment in the setting of an excavated optic nerve in the patient's right eye. Optical coherence tomography confirmed the hydrodynamic separation of the sensory retina from the retinal pigmented epithelium and permitted visualization of a fractured inner-limiting membrane with a contiguous communication between the posterior hyaloid face and the subretinal space at the nasal limit of the detachment. Fluorescein angiography studies identified the absence of chorioretinal vascular compromise contributing to the minimal expansion of the dye into serous cavity late into the study. No optic pit was discernible using optical coherence tomography imaging or fluorescein angiography. CONCLUSIONS: Although glaucomatous damage of the optic nerve has rarely been shown to predispose an individual to serous complications within the macula, recent reports attest to its pathogenic capacity and propose a theory to explain their infrequent clinical coexistence. This case provides additional support for the mounting evidence to support the role of a compromised inner-limiting membrane in inducing a macular detachment in the setting of chronically elevated intraocular pressure without evidence of preexisting optic pits.

Adult↗

[Postoperative behavior of intraocular pressure after posterior Nd:YAG laser capsulotomy--critical evaluation in preventive administration of local carbonic anhydrase II inhibitor dorzolamide hydrochloride (Trusopt)].

BACKGROUND: The aim of the present study was to examine the influence of the topical carbonic anhydrase-II-inhibitor dorzolamide hydrochloride (Trusopt) in regarding to behaviour of intraocular eyepressure after Nd:YAG-laser-capsulotomy. PATIENTS AND METHODS: The study was carried out as a double-blind-test. In a period of nine months, 120 patients underwent Nd:YAG-laser-capsulotomy. One group was given dorzolamide hydrochloride (Trusopt), the other group (placebo) remained without medication. The intraocular pressure was measured before capsulotomy and four hours post-op. For statistical evaluation the t-test of not-associated spot-checks was performed. RESULTS: The prophylactic use of the topical carbonic anhydrase-II-inhibitor dorzolamide hydrochloride (Trusopt) after nd:YAG-laser-capsulotomy shows a highly significant lowering of intraocular pressure, i.e. 1.09 mm Hg in the average. CONCLUSIONS: It was demonstrated that a single dose of dorzolamide hydrochloride (Trusopt) after Nd:YAG-laser-capsulotomy could lower intraocular pressure significantly. Prophylactical usage of dorzolamide hydrochloride (Trusopt) is a useful method to prevent the increase of intraocular pressure and thus to protect the eye against hazardous damage.

Aged↗

Progressive low-tension glaucoma: treatment to stop glaucomatous cupping and field loss when these progress despite normal intraocular pressure.

Our thesis, inspired by the experience and teaching of Paul A. Chandler, is that after the optic discs have developed cupping and atrophy from elevated intraocular pressure they tend to become abnormally vulnerable and, in some cases, may continue to deteriorate even if the intraocular pressure is brought to the teens. At this stage they behave the same as in eyes with so-called low-tension glaucoma, which have developed progressive cupping and atrophy with pressures always in the teens. In either case, we find that the progression of cupping and field loss can be stopped by reducing the intraocular pressure to lower levels, preferably to 10 mm Hg or less. We have found that such low pressures are most reliably attained by surgery, using a special technique we call the shell tamponade filtration procedure, which involves the use of a glaucoma shell in conjunction with standard (full-thickness sclerostomy) filtration operations and certain specific operative and perioperative maneuvers. We present nine case reports illustrating our thesis. Glaucomatous cupping and loss of visual field were progressing relentlessly at normal pressures in each case. This progressive deterioration was shown to be arrested by reduction of the pressure to less than 12 mm Hg in 13 eyes.

Aged↗

Efficacy of carteolol hydrochloride 1% vs timolol maleate 0.5% in patients with increased intraocular pressure. Nocturnal Investigation of Glaucoma Hemodynamics Trial Study Group.

PURPOSE: To evaluate the ocular hypotensive effect and safety of carteolol hydrochloride 1% vs timolol maleate 0.5%. METHODS: One hundred seventy-six patients with ocular hypertension or primary open-angle glaucoma were randomly assigned to receive either carteolol 1% twice a day or timolol maleate 0.5% solution twice a day in a randomized, double-masked, multicenter, parallel-group, active-control comparison trial during a 3-month period. RESULTS: After 12 weeks, carteolol 1% reduced the mean +/- SE intraocular pressure from 25.0 +/- 0.3 to 19.5 +/- 0.3 mm Hg; timolol maleate 0.5% reduced the mean intraocular pressure from 25.2 +/- 0.3 to 19.6 +/- 0.3 mm Hg. The mean difference in trough intraocular pressure between carteolol and timolol maleate of -0.14 mm Hg was not significantly (P = .745) different (95% confidence limits, -0.97 to 0.70 mm Hg). Trough pulse and blood pressure also showed no consistent statistically significant differences between groups. The 2-hour postdose pulse, however, demonstrated a greater decrease in the timolol maleate than in the carteolol group (P < .001). Systemic and ocular signs and symptoms were similar between the groups except that the number of treatment-emergent reports of bradycardia was greater in the timolol maleate group (P = .039), and the carteolol group reported fewer ocular symptoms than the timolol maleate group did (P < .01). CONCLUSIONS: Both carteolol 1% and timolol maleate 0.5% are highly effective in lowering intraocular pressure when measured at the end of the dosing interval. Carteolol 1% demonstrates an ocular hypotensive effect and safety profile similar to those of timolol maleate 0.5% solution.

Adolescent↗

The effects of various levels of intraocular pressure on the rabbit's outflow system.

The effects of various levels of intraocular pressure on the morphology of the rabbit outflow system were investigated. In a total of 20 rabbits, intraocular pressure was maintained at various levels between 0-50 mmHg in the experimental eye and at 20 mmHg in the control eye for 1 hr. Flow rates into the eyes were measured by following the movement of a miniscus through a calibrated capillary tube. Progressive increase in pressure lead to distension and enlargement of the ciliary cleft. The meshwork tissues stretched and distended, and the vessels of the angular aqueous plexus had pressure-sensitive giant vacuoles of their endothelium. These vessels were prone to closure at pressures of 30 mmHg and greater. Difficulties associated with quantitation of giant vacuoles in this species were discussed.

Animals↗

[Hormonal homeostasis and intraocular pressure in chronic emotional stress caused by influences acting on the amygdala].

Changes in intraocular pressure, eye hydrodynamics and the amount of hypophyseal, thyroid, adrenal and pancreatic hormones were studied during continuous stimulation of amygdaloid complex or after administration of angiotensin II into the structure in rabbits. The effects involved changes in hormonal homeostasis and elevation of intraocular pressure due to a hypersecretion of intraocular fluid. The administration of angiotensin II during the amygdala stimulation enhanced the changes.

Amygdala↗

The use of latanoprost 0.005% once daily and its effect on intraocular pressure as primary or adjunctive therapy.

The purpose of this study was to evaluate differences in efficacy and safety of latanoprost as monotherapy compared to adjunctive therapy in primary open-angle glaucoma. We reviewed records of 527 patients who were treated with latanoprost as mono- or adjunctive therapy to reduce the intraocular pressure. Each patient was treated at least three months unless they were discontinued due to an adverse event or lack of efficacy. In the monotherapy group (n=49) baseline intraocular pressure of 23.6+/-5.2 mm Hg fell to 18.4+/-4.3 mm Hg after 4.4+/-2.0 months of follow-up; in the adjunctive therapy group (n=39) baseline intraocular pressure of 21.8+/-5.7 mm Hg fell to 16.7+/-4.6 mm Hg following 4.3+/-1.8 months of therapy which was a similar change from baseline for both groups (P > 0.9). No differences were noted in the class or number of medicines to which latanoprost could be added including: beta-blockers, alpha-agonists and topical carbonic anhydrase inhibitors. The reasons for failure with monotherapy were mostly adverse events (10/15 patients) and with adjunctive therapy lack of efficacy (14/16 patients). Latanoprost is similarly effective as monotherapy and as an adjunctive agent in reducing the intraocular pressure. Latanoprost can be added successfully to a variety of classes of glaucoma medicines used commonly as adjunctive therapy.

Adrenergic alpha-Agonists↗

Changes in intraocular pressure associated with the administration of propofol.

The effect of propofol on intraocular pressure (IOP) was measured in 25 patients presenting for elective non-ophthalmological surgery when propofol was used for the induction and maintenance of anaesthesia (together with 67% nitrous oxide in oxygen, and vecuronium). Normocapnia was maintained. After induction of anaesthesia, intraocular pressure was significantly lower than the baseline value; during maintenance IOP never exceeded the preinduction value. There was a temporary decrease in arterial pressure after induction. In nine patients a cutaneous flush was observed and in seven patients there was discomfort on injection. Spontaneous movement in 20% and hiccup in 12% of the patients were observed at the time of tracheal intubation.

Adult↗

Falsely elevated intraocular pressure due to increased central corneal thickness.

PURPOSE: To evaluate whether ocular hypertensive subjects have a higher central corneal thickness than other individuals. METHODS: In this prospective study, 48 subjects with ocular hypertension, 63 patients with open-angle glaucoma, 56 nonglaucomatous patients with diabetes mellitus, and 106 control subjects were evaluated. Corneal thickness was measured by ultrasound pachymetry, and intraocular pressure was determined by Goldmann applanation tonometry. RESULTS: Central corneal thickness was significantly higher in the ocular hypertensive subjects, mean +/- S.D., 592+/-39 microm, than in the patients with glaucoma (536+/-34 microm), the nonglaucomatous patients with diabetes mellitus (550+/-31 microm), and the normal subjects (545+/-33 microm), P<0.001. The three latter groups did not vary significantly in central corneal thickness, P>0.05. CONCLUSION: In some individuals with increased transcorneal measurements of intraocular pressure, the cornea is thicker than in subjects with normal intraocular pressure readings or patients with glaucoma. It suggests that in ocular hypertensive subjects, corneal pachymetry should be performed to rule out an abnormally thick cornea as a reason for falsely high measurements of intraocular pressure.

Adolescent↗

Topical vanadate lowers intraocular pressure in rabbits.

In unanesthetized rabbits the topical application of vanadate lowered intraocular pressure. Tonographic outflow facility and episcleral venous pressure were unaltered by topical vanadate. As estimated from the tonographic data, aqueous humor flow was reduced by approximately 30%. Posterior chamber aqueous humor ascorbate increased in the eye receiving topical vanadate, and this was compatible with a decreased rate of aqueous humor flow. Topical vanadate did not alter anterior chamber aqueous humor protein or cyclic AMP. In five monkeys intraocular pressure was also significantly reduced by topical vanadate.

Administration, Topical↗

Does raised intraocular pressure begin in utero?

AIM: To determine whether fetal and infant growth, as assessed by weight at birth and weight at 1 year, are related to intraocular pressure. METHODS: 717 men and women born in Hertfordshire between 1920 and 1930, for whom records of birth weight and weight at 1 year were available, were examined. Visual fields were assessed using the Takagi central 25 degrees 75 point static threshold screening program. Tonometry was performed using the Perkin's tonometer. The disc was assessed by direct ophthalmoscopy through dilated pupils. RESULTS: A significant inverse relation was found between systolic blood pressure and birth weight. However, no association was found between birth weight or weight at 1 year and intraocular pressure, cup/disc ratio, or visual field defects. CONCLUSIONS: There was no evidence to support fetal or infant growth as being important factors for the subsequent development of raised intraocular pressure.

Aged↗

Effect of head position on intraocular pressure in horses.

OBJECTIVE: To evaluate the effect of head position on intraocular pressure (IOP) in horses. ANIMALS: 30 horses. PROCEDURES: Horses were sedated with detomidine HCl (0.01 mg/kg, IV). Auriculopalpebral nerve blocks were applied bilaterally with 2% lidocaine HCl. The corneas of both eyes were anesthetized with ophthalmic 0.5% proparacaine solution. Intraocular pressures were measured with an applanation tonometer with the head positioned below and above heart level. The mean of 3 readings was taken for each eye at each position for data analysis. The effect of head position on IOP was assessed and generalized estimating equations were used to adjust for the correlation from repeated measures of the same eye and intereye correlation from the same horse. RESULTS: Of the 60 eyes, 52 (87%) had increased IOP when measured below the heart level. A significant difference (mean +/- SE, 8.20 +/- 1.01 mm Hg) was seen in the mean IOP when the head was above (17.5 +/- 0.8 mm Hg) or below (25.7 +/- 1.2 mm Hg) heart level. No significant effect of sex, age, or neck length on IOP change was found. CONCLUSIONS AND CLINICAL RELEVANCE: Head position has a significant effect on the IOP of horses. Failure to maintain a consistent head position between IOP measurements could potentially prevent the meaningful interpretation of perceived aberrations or changes in IOP.

Aging↗