Ibopamine in glaucoma diagnostics: a new pharmacological provocative test

Area of Science:

• Ophthalmology
• Glaucoma Research
• Diagnostic Testing

Background:

• Ibopamine is recognized for its ability to increase intraocular pressure, particularly in eyes with impaired outflow.
• This pharmacological property makes it valuable for provocative testing in glaucoma diagnostics.

Purpose of the Study:

• To evaluate the clinical-diagnostic utility of the ibopamine provocative test.
• To assess the correlation between ibopamine test response and disease progression in glaucoma patients and suspects.

Main Methods:

• An ibopamine provocative test was administered to 175 patients with primary open-angle glaucoma (POAG), 101 glaucoma suspects, 39 normal-tension glaucoma (NTG) patients, and 163 healthy volunteers.
• Perimetric follow-up of at least one year was conducted on selected POAG and glaucoma suspect cohorts to monitor visual field defect progression based on ibopamine test results.

Main Results:

• The ibopamine test yielded positive results in 92% of POAG patients, 61% of glaucoma suspects, and 52% of NTG patients, with no positive results in healthy individuals.
• Ibopamine-positive glaucoma suspects showed a 28% rate of perimetric deterioration over 2.5 years, contrasting with 0% in negative suspects (p=0.038).
• Among POAG patients, 46% of those with a positive ibopamine test exhibited progressive perimetric defects, compared to 8% of test-negative patients (p=0.003).

Conclusions:

• The ibopamine provocative test is a valuable tool for epidemiological screening to identify individuals at risk of developing ocular hypertension or glaucoma.
• It aids in the follow-up of glaucoma suspects, pinpointing those with an elevated risk of visual field defects.