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Klin Monbl Augenheilkd 2017; 234(02): 179-184
DOI: 10.1055/s-0042-123832
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Der Einfluss von Medikamenten auf das Glaukom und den Augeninnendruck

Impact of Drugs on Glaucoma and Intraocular Pressure
T. Schlote
Augenheilkunde, Tagesklinik Ambimed, Basel, Schweiz
› Author Affiliations
Further Information

Publication History

eingereicht 30 October 2016

akzeptiert 14 November 2016

Publication Date:
23 January 2017 (online)

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Zusammenfassung

Hintergrund Eine Reihe von sehr unterschiedlichen Medikamenten können im Rahmen ihrer regulären Anwendung einen unerwünschten Einfluss auf den Augendruck, ein präexistentes Glaukom und die Wirksamkeit von Glaukommitteln ausüben.

Material und Methoden Aktuelle Literaturrecherche in PubMed. Eigene klinische Erfahrungen flossen in die Bewertung von Zusammenhängen ein.

Ergebnisse Topisch und systemisch applizierte Kortikosteroide haben einen komplexen Einfluss auf das trabekuläre Maschenwerk. Neue Erkenntnisse der Genetik verbessern das Verständnis der Pathogenese, obwohl noch viele Fragen offen sind. Arterielle Hypertonie und die antihypertensive Therapie können beide Einfluss nehmen auf Glaukomrisiko, Augendruck und okuläre Perfusion. Die insgesamt noch junge Anti-VEGF-Therapie ist evtl. assoziiert mit einem erhöhten Risiko dauerhafter Augendruckerhöhungen. Systemische Arzneimittel mit parasympathikolytischer Wirkkomponente (v. a. Psychopharmaka) können selten ein Winkelblockglaukom auslösen.

Schlussfolgerung Erkenntnisse über Zusammenhänge zwischen Arzneimitteln wie den systemischen Antihypertensiva und Kortikosteroiden und der glaukomatösen Optikusneuropathie betreffen große Patientengruppen und können auch das Verständnis über die Pathogenese der primären Offenwinkelglaukome verbessern. Es besteht ein großer Bedarf an weiterer klinischer und experimenteller Forschung.

Abstract

Purpose Systemic drugs may have unfavourable effects on intraocular pressure, glaucoma and the efficacy of glaucoma drugs.

Material and Methods The article provides a review of the literature from PubMed and clinical experience.

Results Topical and systemic corticosteroids induce complex changes inside the trabecular meshwork. New genetic results improve the understanding of pathogenetic processes, although many questions are still open. Arterial hypertension and antihypertonic drugs may influence the risk of glaucoma, intraocular pressure and ocular perfusion pressure. Intravitreal anti-VEGF therapy may be associated with the risk of sustained intraocular pressure elevation. Systemic drugs with parasympaticolytic activity (e.g. psychopharmaceuticals) are able to induce acute angle block glaucoma.

Conclusion New insights into the interactions between drugs (e.g. antihypertensives, corticosteroids) and glaucomatous optic neuropathy affect large patient groups and may improve understanding of the underlying pathogenetic processes in open angle glaucoma. There is a great need for further clinical and experimental research.

Schlüsselwörter

Medikamente - Glaukom - Augendruck - unerwünschte Wirkung - Kortikosteroide

Key words

drugs - glaucoma - intraocular pressure - side effects - corticosteroids
 

  • Literatur

  • 1 Ahmadi N, Snidvongs K, Kalish L. et al. Intranasal corticosteroids do not affect intraocular pressure or lens opacity: a systematic review of controlled trials. Rhinology 2015; 53: 290-302
    PubMedGoogle Scholar
  • 2 Armaly MF. Effect of corticosteroid on intraocular pressure and fluid dynamics. Arch Ophthalmol 1963; 70: 482-491
    CrossrefPubMedGoogle Scholar
  • 3 Becker B, Mills DW. Elevated intraocular pressure following corticosteroid eye drops. JAMA 1963; 185: 884-886
    CrossrefPubMedGoogle Scholar
  • 4 Danias J, Germetta R, Ge Y. et al. Gene expression changes in steroid-induced IOP elevation in bovine trabecular meshwork. Invest Ophthalmol Vis Sci 2011; 52: 8636-8645
    CrossrefPubMedGoogle Scholar
  • 5 Faralli JA, Clark RW, Filla MS. et al. NFATc1 activity regulates the expression of myocilin induced by dexamethasone. Exp Eye Res 2015; 130: 9-16
    CrossrefPubMedGoogle Scholar
  • 6 Jeong S, Patel N, Edlund CK. et al. Identification of a novel mucin gene HCG22 associated with steroid-induced ocular hypertension. Invest Ophthalmol Vis Sci 2015; 56: 2737-2748
    CrossrefPubMedGoogle Scholar
  • 7 Clark AF, Wilson K, McCartney MD. et al. Glucocorticoid-induced formation of cross-linked actin networks in cultured human trabecular meshwork cells. Invest Ophthalmol Vis Sci 1994; 35: 281-294
    PubMedGoogle Scholar
  • 8 Raghunathan VK, Morgan JT, Park SA. et al. Dexamethasone stiffens trabecular meshwork, trabecular meshwork cells, and matrix. Invest Ophthalmol Vis Sci 2015; 56: 4447-4459
    CrossrefPubMedGoogle Scholar
  • 9 Aref AA, Scott IU, Oden NL. et al. Incidence, risk factors, and timing of elevated intraocular pressure after intravitreal triamcinolone acetonide injection for macular edema secondary to retinal vein occlusion: SCORE Study Report 15. JAMA Ophthalmol 2015; 133: 1022-1029
    CrossrefPubMedGoogle Scholar
  • 10 Haller JA, Bandello F, Belfort jr. R. et al. Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion twelve-month study results. Ophthalmology 2011; 118: 2453-2460
    CrossrefPubMedGoogle Scholar
  • 11 Schmitz K, Maier M, Clemens CR. et al. [Reliability and safety of intravitreal Ozurdex injections. The ZERO study]. Ophthalmologe 2014; 111: 44-52
    CrossrefPubMedGoogle Scholar
  • 12 Meyer LM, Schönfeld CL. Secondary glaucoma after intravitreal dexamethasone 0.7 mg implant in patients with retinal vein occlusion: a one-year follow-up. J Ocul Pharmacol Ther 2013; 29: 560-565
    CrossrefPubMedGoogle Scholar
  • 13 Kiddee VW, Trope GE, Sheng L. et al. Intraocular pressure monitoring post intravitreal steroids: a systematic review. Surv Ophthalmol 2013; 58: 291-310
    CrossrefPubMedGoogle Scholar
  • 14 Vié AL, Kodjikian L, Malclès A. et al. Tolerance of intravitreal dexamethasone implants in patients with ocular hypertension or open-angle glaucoma. Retina 2017; 37: 173-178
    CrossrefPubMedGoogle Scholar
  • 15 Mathalone N, Arodi-Golan A, Sar S. et al. Sustained elevation of intraocular pressure after intravitreal injections of bevacizumab in eyes with neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2012; 250: 1435-1440
    CrossrefPubMedGoogle Scholar
  • 16 Baek SU, Park IW, Suh W. Long-term intraocular pressure changes after intravitreal injection of bevacizumab. Cutan Ocul Toxicol 2016; 35: 310-314
    CrossrefPubMedGoogle Scholar
  • 17 Bressler SB, Almukhtar T, Bhorade A. et al. Repeated intravitreous ranibizumab injections for diabetic macular edema and the risk of sustained elevation of intraocular pressure or the need for ocular hypertensive treatment. JAMA Ophthalmol 2015; 133: 589-597
    CrossrefPubMedGoogle Scholar
  • 18 Dedania VS, Bakri SJ. Sustained elevation of intraocular pressure after intravitreal Anti-VEGF agents. Retina 2015; 35: 841-858
    CrossrefPubMedGoogle Scholar
  • 19 Fan JT, Johnson DH, Burk RR. Transient myopia, angle-closure glaucoma, and choroidal detachment after oral acetazolamide. Am J Ophthalmol 1993; 115: 813-814
    CrossrefPubMedGoogle Scholar
  • 20 Wolfs RC, Grobee DE, Hofman A. et al. Risk of acute angle-glaucoma after diagnostic mydriasis in nonselected subjects: the Rotterdam Study. Invest Ophthalmol Vis Sci 1997; 38: 2683-2687
    PubMedGoogle Scholar
  • 21 Pandit RJ, Taylor R. Mydriasis and glaucoma: exploding the myth. A systematic review. Diabet Med 2000; 17: 696-699
    PubMedGoogle Scholar
  • 22 Atalay E, Temcelik N, Arici C. et al. The change in intraocular pressure after pupillary dilation in eyes with pseudoexfoliation glaucoma, primary open angle glaucoma, and eyes of normal subjects. Int Ophthalmol 2015; 35: 215-219
    CrossrefPubMedGoogle Scholar
  • 23 Shihadeh WA, Ritch R, Scharf B. et al. Delayed intraocular pressure elevation after pupillary dilation in exfoliation syndrome. Acta Ophthalmol 2011; 89: 560-562
    CrossrefPubMedGoogle Scholar
  • 24 Seitz DP, Campbell RJ, Bell CM. et al. Short-term exposure to antidepressant drugs and risk of acute angle-closure glaucoma among older patients. J Clin Psychopharmacol 2012; 32: 403-407
    CrossrefPubMedGoogle Scholar
  • 25 Chen HY, Lin CL, Lai EW. et al. Association of selective serotonin reuptake inhibitor use and acute angle-closure glaucoma. J Clin Psychiatry 2016; 77: e692-e696
    CrossrefPubMedGoogle Scholar
  • 26 Levy J, Yagev R, Petrova A. et al. Topiramate-induced bilateral angle-closure glaucoma. Can J Ophthalmol 2006; 41: 221-225
    CrossrefPubMedGoogle Scholar
  • 27 Salim S, Shields MB. Glaucoma and systemic diseases. Surv Ophthalmol 2010; 55: 64-77
    CrossrefPubMedGoogle Scholar
  • 28 Zhao D, Cho J, Kim MH. et al. The association of blood pressure and primary open-angle glaucoma: a metaanalysis. Am J Ophthalmol 2014; 158: 615-627
    CrossrefPubMedGoogle Scholar
  • 29 Schuman JS. Effects of systemic beta-blocker therapy on the efficacy and safety of topical brimonidine and timolol. Brimonidine Study Group 1 and 2. Ophthalmology 2000; 107: 1171-1177
    CrossrefPubMedGoogle Scholar
  • 30 Tattersall C, Vernon S, Singh R. Resting pulse rates in a glaucoma clinic: the effect of topical and systemic betablocker usage. Eye (Lond) 2006; 20: 221-225
    CrossrefPubMedGoogle Scholar
  • 31 Harris A, Topouzis F, Wilson MR. et al. Association of the optic disc structure with the use of antihypertensive medications: the Thessaloniki eye study. J Glaucoma 2013; 526-531
    PubMedGoogle Scholar
  • 32 Topouzis F, Wilson MR, Harris A. et al. Association of open-angle glaucoma with perfusion pressure status in the Thessaloniki Eye Study. Am J Ophthalmol 2013; 155: 843-851
    CrossrefPubMedGoogle Scholar
  • 33 Topouzis F, Coleman AL, Harris A. et al. Association of blood pressure status with the optic disk structure in nonglaucoma subjects: the Thessaloniki eye study. Am J Ophthalmol 2006; 142: 60-67
    CrossrefPubMedGoogle Scholar