Anterior uveitis as a side effect of topical brimonidine.
OBJECTIVE
To report anterior uveitis as a late side-effect of topical brimonidine tartrate 0.2% (Alphagan; Allergan Inc., Irvine, California).


METHODS
Four patients aged 79 to 91 (mean, 83) years, who developed acute anterior uveitis while using topical brimonidine for chronic glaucoma, were clinically evaluated for causes of uveitis. When the inflammation had completely cleared, topical brimonidine was recommenced in one eye only to determine causality.


RESULTS
All four patients developed acute granulomatous anterior uveitis, which resolved rapidly on stopping brimonidine and receiving treatment with topical corticosteroids. The uveitis occurred 11 to 15 (mean, 13.8) months after commencement of brimonidine 0.2% twice daily. None of the patients had a previous history of uveitis, and no other identifiable cause of uveitis was found. In all patients, on rechallenge with brimonidine instilled twice daily to one eye, uveitis recurred within 3 weeks in that eye only.


CONCLUSIONS
These findings suggest that brimonidine can cause anterior uveitis as a late side effect. The inflammation settles rapidly on stopping the medication and on using topical corticosteroids and recurs on rechallenge with brimonidine.
Byles
D B
DB
Oxford Eye Hospital, Oxford, England, UK.
Frith
P
P
Salmon
J F
JF
D000208:Acute Disease; D000287:Administration, Topical; D000316:Adrenergic alpha-Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000187:drug effects; D000068438:Brimonidine Tartrate; D005260:Female; D005901:Glaucoma / Q000188:drug therapy; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D009883:Ophthalmic Solutions / Q000009:adverse effects / Q000627:therapeutic use; D011810:Quinoxalines / Q000009:adverse effects* / Q000627:therapeutic use; D012008:Recurrence; D014606:Uveitis, Anterior / Q000139:chemically induced* / Q000175:diagnosis; D014792:Visual Acuity
D000316:Adrenergic alpha-Agonists; D009883:Ophthalmic Solutions; D011810:Quinoxalines; D000068438:Brimonidine Tartrate