Toxic conjunctivitis caused by bimonidine tartrate

Year 2021, Volume: 4 Issue: 1, 61 - 64, 18.09.2021

Abdullah Beyoğlu , Ali Meşen , Hüseyin Güzel

Abstract

Two patients have been analyzed, which allergic conjunctivitis has been diagnosed due to topical usage of Brimonidine Tartrate 0.2%. The first patient has been followed up for 3 years and the second patient has been followed up for 1 year at another center with glaucoma diagnosis. Both patients who used brimonidine tartrate 0.2% were found to have complaints of excessive redness, irritation, pain and blurred vision in their eyes for the last 4 months and to use topical antibiotic and steroid drops with conjunctivitis and episcleritis diagnosis. An examination of these patients both eye conjunctiva were excessively hyperemic and edematous and extensive giant follicles were detected. Intraocular pressure was controlled by discontinuing brimonidine treatment and adding treatment with topical beta-blocker, carbonic anhydrase inhibitor and loteprednol. The allergic reaction completely disappeared within 1 month.

Keywords

Brimonidine, side effect, allergy, follicles, glaucoma

Brimonidin tartrata bağlı ortaya çıkan toksik konjonktivit

Abstract

Topikal brimonidin tartrat %0.2 kullanımına bağlı allerjik konjonktivit saptanan iki hasta tartışıldı. Birinci hasta 3 yıldır ikinci hasta ise 1 yıldır glokom tanısı ile başka merkezde takip ediliyordu. Brimonidin tartrat %0.2 kullanan her iki hastanın, son 4 aydır gözlerinde aşırı kızarıklık, sulanma, ağrı ve bulanık görme şikayetleri olduğu ve konjonktivit ve episklerit tanılarıyla topikal antibiyotik ve steroid damla kullandığı öğrenildi. Muayenelerinde her iki göz konjonktiva ileri derecede hiperemik ve ödemliydi ve yaygın dev foliküller saptandı. Brimonidin tedavisi kesilerek, topikal beta-blokör, karbonik anhidraz inhibitörü ve loteprednol tedavisi başlanmasıyla göz içi basıncı (GİB) kontrol altına alındı. Allerjik reaksiyon 1 ay içinde tamamen kayboldu.

Keywords

Brimonidin, yan etki, allerji, foliküller, glokom

References

• 1) Walters TR: Development and use of brimonidine in treating acute and chronic elevations of intraocular pressure: a review of safety, efficacy, dose response, and dosing studies. Surv Ophthalmol 1996;41 (1):19-26
• 2) Ermis SS, Özturk F, İnan UU: The short-term IOP-lowering effect of brimonidine 0.2% and dorzolamide 2% combination in primary open-angle glaucoma. Acta Ophthalmol Scand 2002; 80 (6): 632-2.
• 3) Toris CB, Gleason ML, Camras CB: Effects of brimonidine on aqueous humor dynamics in human eyes. Arch Ophthalmol, 1995;113 (12):1514-7.
• 4) Bozkurt B, İrkeç M: Topikal Brimonidin Tartrat %0.2 Kullanımına Bağlı Ortaya Çıkan Allerjik Konjonktivit ve Yüksek Göz İçi Basıncı.[ Allergic Conjunctivitis and Elevated Intraocular Pressure Associated with The Use of Brimonidine Tartrate 0.2% ]. Glokom-Katarakt 2006; 1:67-9.
• 5) LeBlanc RP, Brimonidine study group 2: Twelve-month results of an ongoing randomized trial comparing brimonidine tartrate 0.2% and timolol 0.5% given twice daily in patients with glaucoma and ocular hypertension. Ophthalmology 1998;105 (10):1960-7.
• 6) Katz LJ and the Brimonidine Study Group: Brimonidine tartrate 0.2% twice daily vs timolol 0.5% twice daily: 1-year results in glaucoma patients. Am J Ophthalmol 1999;127 (1):20-6.
• 7) Osborne SA, Montgomery DM, Morris D, McKay IC: Alphagan allergy may increase the propensity for multiple eye-drop allergy. Eye 2005;19 (2):129-37.
• 8) Watts P, Hawksworth N: Delayed hypersensitivity to brimonidine tartrate 0.2% associated with high intraocular pressure. Eye 2002;16 (2):132-5.
• 9) Mushtag B, Sardar J, Matthews TD: A paradoxical ocular effect of brimonidine. Am J Ophthalmol 2003;135 (1):102-10.
• 10) Byles DB, Frith P, Salmon PJ: Anterior uveitis as a side effect of topical brimonidine. Am J Ophthalmol 2000;130 (3):287-91.