Abstract
Purpose
Several different topical eye drop medications are used to lower the intraocular pressure of glaucoma patients. Among them, 0.1% brimonidine tartrate is commonly used and accompanies allergic conjunctivitis as a side effect. This study determined the correlation between the severity of allergic conjunctivitis arising from brimonidine eye drop use and systemic allergic disease.
Methods
A case report study of 63 selected patients diagnosed with open-angle glaucoma or normal-tension glaucoma, and developing allergic conjunctivitis due to brimonidine usage was conducted. The study surveyed patients with newly diagnosed allergic conjunctivitis in terms of allergic rhinitis, asthma, and urticaria symptoms, and a slit lamp examination was used to determine the severity of allergic conjunctivitis in the clinic, using a novel scoring system to establish correlations of interest.
Results
There was no correlation between asthma and the severity of allergic conjunctivitis (r = −0.095, p = 0.461). Allergic rhinitis showed no significant correlation with the severity of allergic conjunctivitis (r = 0.117, p = 0.361), and urticaria displayed no significant correlation with allergic conjunctivitis (r = −0.110, p = 0.389). We found no correlation in glaucoma patients between brimonidine eye drop use and the severity of allergic conjunctivitis.
Figures and Tables
References
3. Collaborative Normal-Tension Glaucoma Study Group. The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma. Am J Ophthalmol. 1998; 126:498–505.
4. Shazly TA, Latina MA. Comparison of intraocular pressure-lowering effect of every night versus every other night dosing of bimatoprost 0.03%. J Ocul Pharmacol Ther. 2011; 27:369–371.
5. The AGIS investigators. The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration. Am J Ophthalmol. 2000; 130:429–440.
6. Katsanos A, Dastiridou AI, Fanariotis M, et al. Bimatoprost and bimatoprost/timolol fixed combination in patients with open-angle glaucoma and ocular hypertension. J Ocul Pharmacol Ther. 2011; 27:67–71.
7. Rahman MQ, Ramaesh K, Montgomery DM. Brimonidine for glaucoma. Expert Opin Drug Saf. 2010; 9:483–491.
8. Blondeau P, Rousseau JA. Allergic reactions to brimonidine in patients treated for glaucoma. Can J Ophthalmol. 2002; 37:21–26.
9. Manni G, Centofanti M, Sacchetti M, et al. Demographic and clinical factors associated with development of brimonidine tartrate 0.2%-induced ocular allergy. J Glaucoma. 2004; 13:163–167.
10. Shiraki Y, Shoji J, Inada N. Clinical usefulness of monitoring expression levels of CCL24 (Eotaxin-2) mRNA on the ocular surface in patients with vernal keratoconjunctivitis and atopic keratoconjunctivitis. J Ophthalmol. 2016; 2016:3573142.
11. Mimura T, Usui T, Yamagami S, et al. Relationship between total tear IgE and specific serum IgE in autumnal allergic conjunctivitis. Cornea. 2013; 32:14–19.
12. Shoji J, Inada N, Sawa M. Evaluation of novel scoring system named 5-5-5 exacerbation grading scale for allergic conjunctivitis disease. Allergol Int. 2009; 58:591–597.
13. Beckers HJ, Schouten JS, Webers CA, et al. Side effects of commonly used glaucoma medications: comparison of tolerability, chance of discontinuation, and patient satisfaction. Graefes Arch Clin Exp Ophthalmol. 2008; 246:1485–1490.
14. Robin AL, Covert D. Does adjunctive glaucoma therapy affect adherence to the initial primary therapy? Ophthalmology. 2005; 112:863–868.
15. Olthoff CM, Schouten JS, van de, Webers CA. Noncompliance with ocular hypotensive treatment in patients with glaucoma or ocular hypertension an evidence-based review. Ophthalmology. 2005; 112:953–961.
16. Cooper J. Improving compliance with glaucoma eye-drop treatment. Nurs Times. 1996; 92:36–37.
17. Melamed S, David R. Ongoing clinical assessment of the safety profile and efficacy of brimonidine compared with timolol: year-three results. Brimonidine Study Group II. Clin Ther. 2000; 22:103–111.
18. Schuman JS, Horwitz B, Choplin NT, et al. Chronic Brimonidine Study Group. A 1-year study of brimonidine twice daily in glaucoma and ocular hypertension. a controlled, randomized, multicenter clinical trial. Arch Ophthalmol. 1997; 115:847–852.
19. LeBlanc RP. Brimonidine Study Group 2. Twelve-month results of an ongoing randomized trial comparing brimonidine tartrate 0.2% and timolol 0.5% given twice daily in patients with glaucoma or ocular hypertension. Ophthalmology. 1998; 105:1960–1967.
20. Chotani MA, Flavahan S, Mitra S, et al. Silent alpha(2C)-adrenergic receptors enable cold-induced vasoconstriction in cutaneous arteries. Am J Physiol Heart Circ Physiol. 2000; 278:H1075–H1083.
21. Katz LJ. Brimonidine tartrate 0.2% twice daily vs timolol 0.5% twice daily: 1-year results in glaucoma patients. Brimonidine Study Group. Am J Ophthalmol. 1999; 127:20–26.
22. Rahman MQ, Montgomery DM, Lazaridou MN. Surveillance of glaucoma medical therapy in a Glasgow teaching hospital: 26 years' experience. Br J Ophthalmol. 2009; 93:1572–1575.