Abstract • In 12 patients with ocular hypertension and similar pressures in each eye, one eye was randomly selected in a masked manner for pretreatment with three applications of topical 0.01% dexamethasone sodium phosphate drops prepared in artificial tears. The other eye was treated with three applications of drops of artificial tears alone. Both eyes were then treated with 0.1% epinephrine hydrochloride drops. Ocular pressures were measured for the next 2 hours at 20-minute intervals. When compared with eyes treated with epinephrine drops alone, eyes pretreated with dexamethasone drops showed a significantly greater decrease in pressure (mean [±SD] maximum difference, 3.1±2.1 mm Hg). Five patients had a difference of 1.0 to 4.0 mm Hg and five patients had a difference of 4.0 to 6.0 mm Hg. Two patients showed no response. Younger age was associated with the greater response. Adrenergic-glucocorticoid synergism resulting in the lowering of ocular pressure may offer a potential for therapeutic use in ocular hypertension and glaucoma. References 1. Stiles GL, Caron MG, Lefkowitz RJ. Betaadrenergic receptors: biochemical mechanisms of physiological regulations . Physiol Rev . 1984;64:661-743. 2. Shenfield GM, Hodson ME, Clarke SW. Interaction of corticosteroids and catecholamines in the treatment of asthma . Thorax . 1975;30:430-435.Crossref 3. Franklin W, Michelson AL, Lowell FC, Schilter IW. Bronchodilators and corticosteroids in the treatment of obstructive pulmonary emphysema . N Engl J Med . 1958;258:774-778.Crossref 4. Harris MA, Schwartz B. Steroid potentiation of beta adrenergic sensitive adenylate cyclase in rabbit ciliary processes . Invest Opthalmol Vis Sci . 1987;28:1024-1027. 5. Ungricht B, Schwartz B. Enhanced ocular hypotensive response of epinephrine with prior dexamethasone treatment . Invest Ophthalmol Vis Sci . 1985;26( (suppl) ):6. Abstract. 6. Rom M, Bealka N, Schwartz B. Enhanced ocular hypotensive response to epinephrine with prior dexamethasone treatment: dexamethasone dose response in rabbits, and an acute clinical trial in ocular hypertensives . Invest Ophthalmol Vis Sci . 1987;28( (suppl) ):268. Abstract. 7. Snedecor GW, Cochran WG. Statistical Methods . 6th ed. Ames, Iowa: Iowa State University Press; 1967. 8. Seigel S. Non-parametric Statistics for Behavioral Sciences . New York, NY: McGraw Hill International Book Co; 1956. 9. Neufeld AH. The mechanism of action of adrenergic drugs in the eye . In: Drance SM, Neufeld AR, eds. Glaucoma: Applied Pharmacology in Medical Treatment . New York, NY: Grune & Stratton; 1984:277-301. 10. Obstbaum SA, Kolker AE, Phelps CD. Low-dose epinephrine: effect on intraocular pressure . Arch Ophthalmol . 1974;92:118-120.Crossref 11. Langham ME, Kitazawa Y, Hart RW. Adrenergic responses in the human eye . J Pharmacol Exp Ther . 1971;179:47-55. 12. Kitazawa Y. Dose response analysis of ocular hypotensive effects of epinephrine and norepinephrine . Jpn J Ophthalmol . 1972;16:30-38. 13. Kelly J, O'Malley K. Adrenoceptor function and aging . Clin Sci . 1984;66:509-515. 14. Becker B, Morton WR. Topical epinephrine in glaucoma suspects . Am J Ophthalmol . 1966;62:272-277. 15. Havener WH. Ocular Pharmacology . 5th ed. St Louis, Mo: CV Mosby Co; 1983:287-289. 16. Schwartz B. Responses of ocular pressure to corticosteroids: corticosteroids and the eye . Int Ophthalmol Clin . 1966;6:929-989.Crossref 17. Yablonski ME, Burde RM, Kolker AE, Becker B. Cataracts induced by topical dexamethasone in diabetics . Arch Ophthalmol . 1978;96:474-476.Crossref 18. Donshik PC, Cavanaugh HD, Boruchoff SA, Dohlman CH. Posterior subcapsular cataracts induced by topical corticosteroids following keratoplasty for keratoconus . Ann Ophthalmol . 1981;13:29-32. 19. Armaly MF. Steroids and glaucoma: symposium on glaucoma . Trans New Orleans Acad Ophthalmol . 1967:74-128. 20. Podos SM, Becker, B. Intraocular pressure effects of diluted and new topical corticosteroids . In: Leopold IH, ed. Symposium on Ocular Therapy: I . St Louis, Mo: CV Mosby Co; 1972;5:90-95.
Archives of Ophthalmology – American Medical Association
Published: Mar 1, 1991