[Current therapeutic possibilities for uveal ocular hypertension].

Objective: to evaluate the efficacy of combination therapy with three antiglaucoma agents (dorzolamide + brimonidine/timolol) for uveal ocular hypertension.

Material And Methods: The study enrolled 20 patients with anterior uveitis complicated by intraocular pressure (IOP) elevation. Besides standard anti-inflammatory agents, the treatment included IOP-lowering instillations, namely dorzolamide 2% 3 times daily and timolol 0.5% 2 times daily. Those patients whose IOP remained uncompensated were then switched to a three-drug regimen: dorzolamide 2% 3 times daily and a fixed combination of brimonidine 0.2%, an aLPHA2-receptor agonist, and timolol 0.5%, a 3-blocker, 2 times daily (Combigan, Allergan). IOP was measured with Maklakov tonometer three times during the day before the treatment and then three times daily while performing the two- or three-drug combination therapy.

Results: The mean initial IOP was 34.57 +/- 0.09 mmHg with daily fluctuations of 5.2 +/- 0.08 mmHg. After starting the unfixed combination therapy (dorzolamide + timolol) the mean IOP decreased by 7.86 +/- 0.07 mmHg. Switching to the three-drug therapy (dorzolamide+ brimonidine/timolol) enabled an additional decrease in IOP by 5.43 +/- 0.06 mmHg. Thus, with the new regimen the total decrease in IOP averaged 13.29 +/- 0.09 mmHg with daily fluctuations of 2.5?0.06 mmHg, which ensured that the target IOP was achieved in all patients. All the drugs were well-tolerated.

Conclusion: Combination therapy with three antiglaucoma agents in the form of two medications--dorzolamide 2% and brimonidine/timolol fixed combination (Combigan)--is shown to be effective in uveal ocular hypertension patients.