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Exposure to topical apraclonidine in children with glaucoma.

Publication ,  Journal Article
Wright, TM; Freedman, SF
Published in: J Glaucoma
2009

PURPOSE: The topical alpha-2 adrenergic agonist, brimonidine, although effective at intraocular pressure (IOP) reduction in adults, is contraindicated in infants/small children due to severe systemic side effects. The topical alpha-2 adrenergic agonist apraclonidine, used for short-term IOP reduction in adults, and described for Horner's syndrome testing, has recently been reported to cause systemic side effects in children. We have used topical apraclonidine 0.5% to treat infants and small children with glaucoma undergoing angle surgery, and selected children needing additional IOP reduction. Here we evaluate the safety of topical apraclonidine 0.5% when used in children with glaucoma. METHODS: Retrospective chart review of sequential children with glaucoma, having angle surgery or examination under anesthesia at Duke Eye Center from 1995 to 2006, who received topical apraclonidine 0.5%. Demographic and glaucoma-related information were noted, including any reported side effects. RESULTS: In all, 115 eyes of 75 pediatric glaucoma patients received apraclonidine 0.5% drops, for a total 179 treatment sessions. Most sessions (91%, 162/179) occurred during and after angle surgery, primarily in children with congenital/infantile glaucoma (53%, 40/75). Median age at apraclonidine exposure was 5.3 months (range, 0.1 mo to 17 y). Median number of apraclonidine dose exposures was 15 (range, 4 to 5745); median number of concurrent glaucoma medications was 3. Nonthreatening side effects were noted in 8% (6/75) total children: topical allergy (2 children), lethargy (3 children), and decreased appetite (1 child). CONCLUSIONS: In contrast to brimonidine, topical apraclonidine 0.5% can safely be administered for short-term treatment of most infants and children undergoing angle surgery for glaucoma, rarely producing systemic side effects.

Duke Scholars

Published In

J Glaucoma

DOI

EISSN

1536-481X

Publication Date

2009

Volume

18

Issue

5

Start / End Page

395 / 398

Location

United States

Related Subject Headings

  • Trabeculectomy
  • Retrospective Studies
  • Postoperative Care
  • Ophthalmology & Optometry
  • Male
  • Lethargy
  • Intraoperative Care
  • Infant, Newborn
  • Infant
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wright, T. M., & Freedman, S. F. (2009). Exposure to topical apraclonidine in children with glaucoma. J Glaucoma, 18(5), 395–398. https://doi.org/10.1097/IJG.0b013e31818624e5
Wright, Tarra M., and Sharon F. Freedman. “Exposure to topical apraclonidine in children with glaucoma.J Glaucoma 18, no. 5 (2009): 395–98. https://doi.org/10.1097/IJG.0b013e31818624e5.
Wright TM, Freedman SF. Exposure to topical apraclonidine in children with glaucoma. J Glaucoma. 2009;18(5):395–8.
Wright, Tarra M., and Sharon F. Freedman. “Exposure to topical apraclonidine in children with glaucoma.J Glaucoma, vol. 18, no. 5, 2009, pp. 395–98. Pubmed, doi:10.1097/IJG.0b013e31818624e5.
Wright TM, Freedman SF. Exposure to topical apraclonidine in children with glaucoma. J Glaucoma. 2009;18(5):395–398.

Published In

J Glaucoma

DOI

EISSN

1536-481X

Publication Date

2009

Volume

18

Issue

5

Start / End Page

395 / 398

Location

United States

Related Subject Headings

  • Trabeculectomy
  • Retrospective Studies
  • Postoperative Care
  • Ophthalmology & Optometry
  • Male
  • Lethargy
  • Intraoperative Care
  • Infant, Newborn
  • Infant
  • Humans