Published October 30, 2023 | Version http://impactfactor.org/PDF/IJTPR/13/IJTPR,Vol13,Issue10,Article14.pdf
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Short Time Effect of 2% Pilocarpine Eye Drops on Intra Ocular Pressure

  • 1. Associate Professor, Department of Ophthalmology, GITAM Institute of Medical Sciences & Research, Visakhapatnam – 530 045 Andhra Pradesh
  • 2. Department of Ophthalmology, GITAM Institute of Medical Sciences & Research, Visakhapatnam – 530 045 Andhra Pradesh.
  • 3. Asst. Professor, Department of Ophthalmology, GITAM Institute of Medical Sciences & Research, Visakhapatnam – 530 045 Andhra Pradesh.
  • 4. Professor & HOD, Department of Ophthalmology, GITAM Institute of Medical Sciences & Research, Visakhapatnam – 530 045 Andhra Pradesh.
  • 5. Department of Microbiology, GSL Medical College, Rajahmundry – 533 296.

Description

Introduction: Pilocarpine is direct acting parasympathomimetic agent, acts on autonomic nervous system. Intra ocular pressure (IOP) is the major risk factor for the development of glaucoma. A study was conducted to find the short time effect of 2% Pilocarpine eye drops on IOP. Methods:  This was a hospital based, prospective study, conducted in the department of Ophthalmology, GITAM Institute of Medical sciences & Research, Visakhapatnam. Study was conducted between January to June 2023. Individuals aged > 20 years, both gender diagnosed to be angle closure glaucoma and different subtypes were included in this research. The preprocedural IOP was recorded with goldman applanation tonometer, recorded in milli meters of mercury (mm Hg). Pilocarpine eye drops at 2% concentration was instilled to both eyes for every 30 minutes for 2 hours and IOP was measured. The data were represented in mean + SD. ANOVA test was used for the statistical analysis. P<0.05 was considered to be statistically significant. Results: Total 50 members were included, female male ratio was 2.3. Maximum (24%) study members were in 40 – 50 years group and minimum (8%) in < 20 years group. The mean + SD IOP was 17.3 + 6.2498 and 14.52 + 5.1217, respectively in pre and post administration of 2% pilocarpine eye drops; statistically there was significant difference (P = 0.001). Conclusions: Pilocarpine can bring significant IOP reduction among the glaucoma individuals. But small sample size, short duration of study and not reporting the diurnal and nocturnal data are the limitations of the study. Studies on large sample size for long time is recommended.

Abstract (English)

Introduction: Pilocarpine is direct acting parasympathomimetic agent, acts on autonomic nervous system. Intra ocular pressure (IOP) is the major risk factor for the development of glaucoma. A study was conducted to find the short time effect of 2% Pilocarpine eye drops on IOP. Methods:  This was a hospital based, prospective study, conducted in the department of Ophthalmology, GITAM Institute of Medical sciences & Research, Visakhapatnam. Study was conducted between January to June 2023. Individuals aged > 20 years, both gender diagnosed to be angle closure glaucoma and different subtypes were included in this research. The preprocedural IOP was recorded with goldman applanation tonometer, recorded in milli meters of mercury (mm Hg). Pilocarpine eye drops at 2% concentration was instilled to both eyes for every 30 minutes for 2 hours and IOP was measured. The data were represented in mean + SD. ANOVA test was used for the statistical analysis. P<0.05 was considered to be statistically significant. Results: Total 50 members were included, female male ratio was 2.3. Maximum (24%) study members were in 40 – 50 years group and minimum (8%) in < 20 years group. The mean + SD IOP was 17.3 + 6.2498 and 14.52 + 5.1217, respectively in pre and post administration of 2% pilocarpine eye drops; statistically there was significant difference (P = 0.001). Conclusions: Pilocarpine can bring significant IOP reduction among the glaucoma individuals. But small sample size, short duration of study and not reporting the diurnal and nocturnal data are the limitations of the study. Studies on large sample size for long time is recommended.

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Additional details

Dates

Accepted
2023-09-20

References

  • 1. Skaat A, Rosman MS, Chien JL, et al. Effect of Pilocarpine Hydrochloride on the Schlemm Canal in Healthy Eyes and Eyes with OpenAngle Glaucoma. JAMA Ophthalmol. 2016; 13 4(9):976 – 98. 2. Holmstedt B, Wassén SH, Schultes RE. Jaborandi: an interdisciplinary appraisal. Journal of Ethnopharmacology. 1 1979. 1: 3 – 21. 3. Kannarr S, El-Harazi SM, Moshirfar M, Lievens C, Kim JL, Peace JH, Safyan E, Liu H, Zheng S, Robinson MR. Safety and Efficacy of Twice-Daily Pilocarpine HCl in Presbyopia: The Virgo Phase 3, Randomized, Double-Masked, Controlled Study. Am J Ophthalmol. 2023; 253: 189 - 200. 4. Macri, FJ, Cevario SJ. The dual nature of pilocarpine to stimulate or inhibit the formation of aqueous humor. Invest Opthol. 1974; 13: 617. 5. Seibold LK, Wagner BD, Lynch AM, Kahook MY. The Diurnal and Nocturnal Effects of Pilocarpine on Intraocular Pressure in Patients Receiving Prostaglandin Analog Monotherapy. J Ocul Pharmacol Ther. 2018; 34(8): 590 – 5. 6. Kinney M, Johnson AD, Reddix M, McCann MB. Temporal Effects of 2% Pilocarpine Ophthalmic Solution on Human Pupil Size and Accommodation. Mil Med. 2020; 185: 435 – 42. 7. Mosler MP, Werner JU, Lang GK. Kammerwinkelbeurteilung im klinischen Alltag - ein Vergleich zwischen der optischen Kohärenztomografie und der Gonioskopie [Chamber Angle Assessment in Clinical Practice - A Comparison between Optical Coherence Tomography and Gonioscopy]. Klin Monbl Augenheilkd. 2015; 232(7): 874 - 80. 8. Senjam SS. Glaucoma blindness-A rapidly emerging non-communicable ocular disease in India: Addressing the issue with advocacy. J Family Med Prim Care. 2020; 9(5): 2200 – 6. 9. Allison K, Patel D, Alabi O. Epidemiology of Glaucoma: The Past, Present, and Predictions for the Future. Cureus. 2020; 12(11): e11686. 10. Palimkar A, Khandekar R, Venkataraman V. Prevalence and distribution of glaucoma in central India (Glaucoma Survey 2001). Indian J Ophthalmol. 2008; 56(1): 57 – 62. 11. Kass MA, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, Parrish RK 2nd, Wilson MR, Gordon MO. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002; 120(6): 701 – 13. 12. Soderstrom MB, Wallin O, Granström PA, et al. Timololpilocarpine combined vs timolol and pilocarpine given separately. Am J Ophthalmol 1989; 107: 465 –70. 13. Nordmann JP, Söderström M, Rouland JF, Malecaze F. Comparison of the intraocular pressure lowering effect of latanoprost and a fixed combination of timolol-pilocarpine eye drops in patients insufficiently controlled with beta adrenergic antagonists. French Latanoprost Study Group, and the Swedish Latanoprost Study Group. Br J Ophthalmol. 2000; 84 (2):181–5.