Terbutaline stimulates aqueous humor flow in humans during sleep

A randomized, double-masked study of the effect of terbutaline sulfate, a selective beta 2-agonist, on the rate of aqueous humor formation was performed in awake and sleeping normal human subjects. The rate of aqueous formation was measured by fluorophotometry. Both the drug- and placebo-treated eyes showed a statistically significant nocturnal reduction of the flow rate (36% suppression in the terbutaline-treated eyes and 43% suppression in the placebo-treated eyes). Terbutaline had no effect on daytime aqueous flow rates, but stimulated flow by 15% during sleep. The drug had no significant effect on intraocular pressure. This study confirms past observations that beta-agonists exert their maximal effects during sleep, when endogenous adrenergic stimulation is at a minimum.