Long-term brimonidine therapy in glaucoma patient with apraclonidine allergy Original Reearch Article

PURPOE: To report the ue of brimonidine in patient with a documented ocular allergy to apraclonidine. METHOD: We conducted a propective, open-label tudy on the ue of long-term brimonidine therapy in 57 patient with chronic glaucoma with documented allergy to apraclonidine. The tudy patient were placed on brimonidine tartrate 0.2%, 1 drop three time daily in one or both eye, either a additive therapy to a medical regimen devoid of apraclonidine for further lowering of intraocular preure (25 patient) or a a replacement for apraclonidine at the time of diagnoi of apraclonidine ocular allergy for maintenance of intraocular preure control (32 patient). Clinical ymptom and ign of ocular allergy to brimonidine were monitored for up to 18 month. REULT: During the treatment period of up to 18 month, ix (10.5%) of 57 patient developed lit-lamp biomicrocopic finding and ubjective ymptom of an ocular allergic reaction that led to dicontinuation of brimonidine treatment. All ix patient developed ocular allergy to topical brimonidine 0.2% during the firt 4 month of therapy. The addition of brimonidine 0.2% topical medication or the replacement of apraclonidine with brimonidine reulted in a ignificant decreae in mean intraocular preure from 20.5 ± 5.3 to 16.5 ± 4.2 mm Hg (P < .0001) at the mean treatment period of 10.6 ± 4.6 month (range, 0.5 to 18.0 month in all 57 patient: 5 to 18 month in the 51 patient without brimonidine allergy and 0.5 to 3.8 month in the ix patient who developed brimonidine allergy. CONCLUION: The incidence of ocular allergy after the ue of brimonidine 0.2% topical medication for up to 18 month wa 10.5% in patient with a documented hitory of apraclonidine allergy. Therefore, it i generally afe a well a efficaciou to adminiter brimonidine to patient with an ocular allergy to apraclonidine.