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Adverse Events and Intraocular Pressure-Lowering Effect of Topical 0.5% Apraclonidine in Childhood Glaucoma: A
Abdelrahman M Elhusseiny1, Marie Michele Macaron2, Amr K Hassan3
1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Department of Ophthalmology, Boston Children's Hospital, Harvard University, Boston, Massachusetts; Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Insights
Topical apraclonidine is safe and effective for reducing intraocular pressure (IOP) in children with glaucoma. This study found a low incidence of adverse events and significant IOP reduction when used as an add-on therapy.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Pharmacology
Background:
- Childhood glaucoma requires effective management to prevent vision loss.
- Intraocular pressure (IOP) control is crucial in managing pediatric glaucoma.
- Topical apraclonidine is a potential adjunctive therapy for IOP reduction.
Purpose of the Study:
- To assess the safety and efficacy of topical apraclonidine in pediatric glaucoma patients.
- To evaluate adverse events associated with apraclonidine use in children.
- To determine the intraocular pressure (IOP)-lowering effects of apraclonidine in childhood glaucoma.
Main Methods:
- Retrospective case series analysis of childhood glaucoma patients (<18 years).
- Data extraction included demographics, ocular and systemic adverse events, and IOP.
- Childhood glaucoma classification followed the Childhood Glaucoma Research Network criteria.
Main Results:
- 108 eyes from 90 patients were analyzed.
- No local adverse events were reported; only two cases of systemic events (night terror, somnolence).
- Mean IOP decreased from 30±4.6 mmHg at baseline to 24.9±4 mmHg at 6 months.
Conclusions:
- Topical apraclonidine shows a low rate of adverse events in childhood glaucoma.
- Apraclonidine provides clinically significant IOP reduction as adjunctive therapy.
- This medication is a viable option for managing pediatric glaucoma.
Purpose:
To evaluate the adverse events and intraocular pressure (IOP)-lowering effects of topical apraclonidine in childhood glaucoma management.
Design:
A retrospective case series.
Participants:
Glaucoma patients aged ≤18 years who had received topical apraclonidine.
Methods:
We extracted data on demographics, ocular and systemic adverse events, and IOP reduction. We defined and classified childhood glaucoma based on the Childhood Glaucoma Research Network criteria.
Main Outcome Measures:
Adverse events and IOP-lowering effect of topical 0.5% apraclonidine.
Results:
We included 108 eyes (90 patients). Glaucoma associated with non-acquired systemic disease or syndrome (36 eyes, 33.3%) was the most common diagnosis, followed by glaucoma following cataract surgery (29 eyes, 26.9%). The median age at glaucoma diagnosis was 32 months (interquartile range [IQR]: 5.3-68.5 months). The median age at the start of apraclonidine was 5 years (IQR = 3-9). The mean number of glaucoma medications on apraclonidine initiation was 2.7 ± 0.8. The median duration for apraclonidine use was 327 days (IQR = 42-665). There were no local adverse events reported, and only 2 cases of systemic adverse events (1 case [1.1%] of night terror and 1 case [1.1%] of somnolence). The mean baseline IOPs was 30 ± 4.6 mmHg (n = 85 eyes), with a mean IOP reduction of 5.3 mmHg at 6 months after use (n = 20 eyes).
Conclusions:
Topical apraclonidine use demonstrated a low rate of reported adverse events and was associated with clinically meaningful IOP reduction as an adjunctive treatment in childhood glaucoma.
Financial Disclosure(S):
The authors have no proprietary or commercial interest in any materials discussed in this article.
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