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Bulbar conjunctival follicles associated with dipivefrin therapy
Ophthalmology
|February 1, 1985
Summary
Dipivefrin therapy for glaucoma can cause large conjunctival follicles, an irritant reaction. These follicles resolved after discontinuing dipivefrin, suggesting it as the cause, not allergies or preservatives.
Area of Science:
- Ophthalmology
- Pharmacology
Background:
- Chronic open-angle glaucoma requires long-term management.
- Dipivefrin is a prodrug used to treat glaucoma.
Purpose of the Study:
- To investigate the cause of large bulbar conjunctival follicles observed in patients using dipivefrin.
- To differentiate between irritant, allergic, or preservative-related reactions.
Main Methods:
- Clinical observation of patients developing conjunctival follicles during dipivefrin therapy.
- Discontinuation of dipivefrin to assess reaction resolution.
- Giemsa staining of conjunctival scrapings.
- Conjunctival biopsy analysis.
- Patch testing.
Main Results:
- Twelve patients developed large bulbar conjunctival follicles with prolonged dipivefrin use.
- Follicles resolved within one month of discontinuing dipivefrin.
- Clinical course, staining, biopsy, and patch tests indicated an irritant reaction to dipivefrin.
Conclusions:
- Dipivefrin therapy can induce an irritant conjunctival reaction.
- The reaction is likely due to dipivefrin itself, not preservatives or allergy.
- Discontinuation of dipivefrin is effective in resolving these follicles.