Carbonic Anhydrase Inhibitors

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Citation (Scopus)

Abstract

Carbonic anhydrase inhibitors are IOP-lowering sulfonamide derivatives which inhibit the activity of CA in the ciliary processes of the eye, thus reducing aqueous humor formation and consequently decreasing IOP. Systemic CAIs provide an approximately 40% IOP reduction, and their effect develops rapidly. Therefore, systemic CAIs (most frequently acetazolamide) are useful to break acute angle-closure glaucoma and to reduce high IOP prior to filtering surgery. However, when used chronically, systemic CAIs have many systemic side effects. Indeed, some side effects of acetazolamide can even be lethal. In contrast, the topical CAIs dorzolamide and brinzolamide are safe systemically, and their side effects are mostly local. In monotherapy, the IOP decrease achieved with either of these topical CAIs varies between 15% and 20%, a figure which is considerably less than the reduction produced by acetazolamide. In clinical practice, topical CAIs are mainly used as a part of a combined IOP-lowering medication. Their additional IOP-lowering efficacy is especially favorable when they are added to nonselective ß-receptor blockers or prostaglandin analogues. The IOP reduction provided by the topical CAIs is stable over long usage, with no long-term drift phenomenon. In order to increase the ocular penetration, dorzolamide is formulated with an acidic pH, which may explain the more frequent and severe local side effects as compared to brinzolamide. All CAIs influence ocular perfusion, but the clinical significance of the CAI-induced increase of ocular blood flow remains to be specified. At present, the information on the altered ocular perfusion due to CAI administration cannot be interpreted as evidence of IOP-independent retinal ganglion cell protection in glaucoma.

Original languageEnglish
Title of host publicationMedical Diagnosis and Therapy
PublisherElsevier Inc.
Pages559-565
Number of pages7
Volume1
ISBN (Print)9780702055416, 9780702051937
DOIs
Publication statusPublished - Sep 3 2014

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Carbonic Anhydrase Inhibitors
dorzolamide
Acetazolamide
Perfusion
Filtering Surgery
Synthetic Prostaglandins
Angle Closure Glaucoma
Cytoprotection
Retinal Ganglion Cells
Aqueous Humor
Sulfonamides
Glaucoma

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Holló, G. (2014). Carbonic Anhydrase Inhibitors. In Medical Diagnosis and Therapy (Vol. 1, pp. 559-565). Elsevier Inc.. https://doi.org/10.1016/B978-0-7020-5193-7.00054-6

Carbonic Anhydrase Inhibitors. / Holló, G.

Medical Diagnosis and Therapy. Vol. 1 Elsevier Inc., 2014. p. 559-565.

Research output: Chapter in Book/Report/Conference proceedingChapter

Holló, G 2014, Carbonic Anhydrase Inhibitors. in Medical Diagnosis and Therapy. vol. 1, Elsevier Inc., pp. 559-565. https://doi.org/10.1016/B978-0-7020-5193-7.00054-6
Holló G. Carbonic Anhydrase Inhibitors. In Medical Diagnosis and Therapy. Vol. 1. Elsevier Inc. 2014. p. 559-565 https://doi.org/10.1016/B978-0-7020-5193-7.00054-6
Holló, G. / Carbonic Anhydrase Inhibitors. Medical Diagnosis and Therapy. Vol. 1 Elsevier Inc., 2014. pp. 559-565
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