Brinzolamide 10mg/ml eye drops

PurposeThis systematic review and meta-analysis aims to compare BT and DT in terms of intraocular pressure (IOP) reduction, safety, and patient preferences.MethodsFollowing PRISMA and Cochrane guidelines, we searched PubMed, Scopus, Web of Science, CENTRAL, and Embase up to December 30, 2024. Twelve studies (11 randomized controlled trials [RCTs]) involving 1,885 patients were included. Primary outcomes were IOP reduction and adverse events. Statistical analyses were performed using Review Manager 5.4.1, with mean differences (MD) and risk ratios (RR) calculated for continuous and binary outcomes.ResultsBT demonstrated a statistically greater reduction in the morning IOP compared to DT at 12 weeks or more (BT: MD = 0.56 mmHg, P P P P < 0.001). Patient preference studies favored brinzolamide/timolol fixed combination (BTFC) due to reduced ocular discomfort.ConclusionBT showed a statistically greater reduction in morning IOP than DT; however, the absolute difference was modest, and its clinical relevance is uncertain. BT was associated with less ocular irritation but higher blurred vision risk. High heterogeneity for evening IOP and overall adverse events limits interpretation. Considering these findings, the choice of treatment usually depends on the patient's tolerance to higher initial ocular irritation in DT or blurring of vision in BT. Longer-term trials with 24-h IOP and preference are needed to assess these outcomes meaningfully.

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IntroductionIntravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents are a primary management option for retinal diseases. Acute elevation of intraocular pressure (IOP) is a complication associated with these injections that should be considered. This study investigated and compared the prophylactic effects of fixed combination anti-glaucoma medication on IOP spikes following intravitreal anti-VEGF injections.MethodsThis randomized double-blind clinical trial included one eye of each participant indicated for treatment with intravitreal injection of anti-VEGF agents (bevacizumab, aflibercept, and ranibizumab) and randomly allocated to one of the three prophylactic anti-glaucoma medications, with each drug further divided into one- and two-drop regimens before intravitreal injection. Participants with allergies or contraindications to medications were excluded from the pretreatment groups and were invited to participate in the control group.ResultsThe study involved 308 participants: 89 in the dorzolamide/timolol group, 86 in the brimonidine/timolol group, 101 in the brinzolamide/brimonidine group, and 32 in the control group. Baseline characteristics and IOP were comparable across all groups. In the prophylactic premedication groups, mean IOP at 30 min were within 21 mmHg and returned to their baseline at 1 h. Mean IOP measurements between baseline and 30 min in the brimonidine/timolol two-drop regimen were not significantly different: 13.72 ± 4.63 vs 15.11 ± 4.39 mmHg, p = 0.096. In the control group, IOP significantly increased from baseline at 30 min and 1 h post-injection: 14.31 ± 4.10, 22.15 ± 8.64, and 18.36 ± 7.52 mmHg, respectively, p ConclusionTopical fixed combination anti-glaucoma medication used as a prophylactic treatment before intravitreal anti-VEGF injections significantly prevented IOP spikes post-injection, with a comparable effect among three medications. Prophylactic treatment of IOP spikes should be considered as standard care to prevent further damage in patients with compromised retinal vascular and optic nerve perfusion.Trial registrationTCTR20241005001, retrospectively registered.

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Background/Objectives: Rho-associated protein kinase inhibitors reduce intraocular pressure (IOP) by enhancing aqueous humor outflow through the trabecular meshwork-Schlemm's canal pathway. However, it remains unclear whether the fixed-dose combination of ripasudil hydrochloride hydrate and brimonidine tartrate (GLAALPHA) enhances conventional aqueous outflow in vivo. Methods: This single-center randomized clinical trial included healthy adult volunteers who received GLAALPHA, a brimonidine tartrate-brinzolamide fixed-dose combination (Ailamide), or brimonidine tartrate monotherapy (Aiphagan) in a crossover sequence. The aqueous column width in the episcleral veins was assessed at baseline and at 2 h (primary outcome) and 8 h using hemoglobin video imaging. Results: Among 24 participants, analyses included 23 GLAALPHA-treated eyes, 21 Ailamide-treated eyes, and 22 Aiphagan-treated eyes. Two hours after instillation, the aqueous column width significantly increased from baseline only in the GLAALPHA group (p = 0.002). The percent increase in the aqueous column width at 2 h was significantly greater with GLAALPHA than with Ailamide (p = 0.039) and not significantly different between GLAALPHA and Aiphagan (p = 0.114). At 8 h, the aqueous column width did not differ from the baseline in any groups. Conclusions: In healthy adult eyes, GLAALPHA significantly increased the aqueous column width in the episcleral veins 2 h after instillation, indicating enhanced conventional aqueous outflow. These findings provide evidence that GLAALPHA promotes trabecular outflow beyond the effects of brimonidine tartrate-containing comparators and offer mechanistic insights into its action.

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