Mode of action, clinical profile and relevance of carbonic anhydrase inhibitors in glaucoma therapy

• Published in: Klinische Monatsblatter fur Augenheilkunde Vol. 230; no. 2; p. 146
• Main Author: Eichhorn, M
• Format: Journal Article
• Language: German
• Published: Germany 01.02.2013
• Subjects: Animals; Antihypertensive Agents - adverse effects; Antihypertensive Agents - therapeutic use; Aqueous Humor - drug effects; Aqueous Humor - secretion; Carbonic Anhydrase Inhibitors - adverse effects; Carbonic Anhydrase Inhibitors - therapeutic use; Ciliary Body - drug effects; Ciliary Body - physiopathology; Drug Combinations; Glaucoma - drug therapy; Glaucoma - physiopathology; Humans; Intraocular Pressure - drug effects; Intraocular Pressure - physiology; Ophthalmic Solutions; Retinal Vessels - drug effects; Retinal Vessels - physiopathology; Sulfonamides - adverse effects; Sulfonamides - therapeutic use; Thiazines - adverse effects; Thiazines - therapeutic use; Thiophenes - adverse effects; Thiophenes - therapeutic use
• ISSN: 1439-3999
• DOI: 10.1055/s-0032-1328163

Since their introduction the local carbonic anhydrase inhibitors (CAH) dorzolamide and brinzolamide have become well established in the drug therapy of glaucoma. They lower intraocular pressure (IOP) by blocking specifically carbonic anhydrase in the ciliary epithelium and thereby the secretion of aqueous humor. The IOP lowering effect is comparable with that of beta-blockers, but less than that of prostaglandin agonists. Because of their specific mode of action they produce an additive pressure lowering effect with any other glaucoma drug. Therefore they are ideal for being combined with other drugs. In addition, CAH may improve perfusion of the posterior eye. Preliminary results in glaucoma patients under dorzolamide therapy suggesting a reduction in the risk of progression due to enhanced blood flow need further confirmation.