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A paradoxical ocular effect of brimonidine
Bushra Mushtaq1, Jagadish Sardar, Tim D Matthews
1Birmingham and Midland Eye Centre, Birmingham University Hospital Selly Oak, United Kingdom.
American Journal of Ophthalmology
|December 31, 2002
Summary
Topical brimonidine, used for glaucoma, can paradoxically increase intraocular pressure (IOP). This adverse drug reaction requires careful patient monitoring during treatment.
Area of Science:
- Ophthalmology
- Pharmacology
Background:
- Glaucoma management often involves topical medications.
- Brimonidine is a common alpha-adrenergic agonist used to lower intraocular pressure (IOP).
Observation:
- An unusual paradoxical effect of topical brimonidine was observed in a patient with normal tension glaucoma.
- The patient experienced elevated IOP after brimonidine application.
Findings:
- Rechallenge with brimonidine confirmed IOP elevation.
- An adverse drug reaction probability score indicated a strong likelihood of brimonidine causing the paradoxical IOP increase.
Implications:
- Clinicians should be vigilant for paradoxical IOP elevation in patients using topical brimonidine.
- This highlights the need for careful monitoring of intraocular pressure even with standard glaucoma treatments.