Update on topical carbonic anhydrase inhibitors.
Topical carbonic anhydrase inhibitors are a novel addition to the armamentarium of medical glaucoma treatment; dorzolamide has been available since 1995 and brinzolamide since 1998. They lower intraocular pressure by inhibiting carbonic anhydrase, a key enzyme for aqueous humor formation. Intraocular pressure-lowering activity of the substances appears to be the same and is similar to that of most other agents, but it does not reach the activity of the unselective beta-blocker timolol or the prostaglandin latanoprost. On concomitant treatment, additivity is reached with all other topical agents. A possible improvement of blood flow may offer an additional benefit, but its significance for the long-term outcome for human glaucoma remains to be shown. Side effects are mostly local. A more physiologic pH of brinzolamide appears to be advantageous.
Herkel
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Mainz University-Hospital, Mainz, Germany. herkel@augen.klinik.uni-mainz.de
Pfeiffer
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D000959:Antihypertensive Agents / Q000008:administration & dosage; D001082:Aqueous Humor / Q000201:enzymology*; D001783:Blood Flow Velocity / Q000187:drug effects; D002257:Carbonic Anhydrase Inhibitors / Q000008:administration & dosage*; D002256:Carbonic Anhydrases / Q000187:drug effects / Q000378:metabolism*; D004305:Dose-Response Relationship, Drug; D005123:Eye / Q000098:blood supply; D005901:Glaucoma / Q000188:drug therapy* / Q000201:enzymology / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D000077338:Latanoprost; D009883:Ophthalmic Solutions; D011461:Prostaglandins F, Synthetic / Q000008:administration & dosage; D013449:Sulfonamides / Q000008:administration & dosage; D013843:Thiazines / Q000008:administration & dosage; D013876:Thiophenes / Q000008:administration & dosage
D000959:Antihypertensive Agents; D002257:Carbonic Anhydrase Inhibitors; D009883:Ophthalmic Solutions; D011461:Prostaglandins F, Synthetic; D013449:Sulfonamides; D013843:Thiazines; D013876:Thiophenes; D000077338:Latanoprost; C111827:brinzolamide; C062765:dorzolamide; D002256:Carbonic Anhydrases