Beta-blockers have been used since the late 1970's as ‘first-choice’ in the treatment for glaucoma. Since the introduction of new molecules in clinical routine, the current role of beta-blockers in glaucoma therapy has been rediscussed. In particular, concerns have been raised regarding their actual safety profile.
Methods
This review will focus on the latest advances on the efficacy and safety profiles of non-selective beta-blockers.
Conclusions
The data provided will help to trace a more appropriate role for beta-blockers in glaucoma therapy.
NiesA.S., SpielbergS.P.. Principles of therapeutics. In: HardmanJ.G., LimbirdL.E., eds. Goodman and Gillman's the pharmacological basis of therapeutics.New York USA: McGraw Hill, 1996; 54–5.
2.
JachuckS.J., BrierleyH., JachuckS., WilcoxP.M.. The effect of hypotensive drugs on the quality of life.J R Coll Gen Pract1982; 32: 103–5.
3.
Kobelt-NguyenG., GerdthamU.G., AlmA.. Cost of treating primary open angle glaucoma and ocular hypertension. A retrospective 2-year chart review of newly diagnosed patients in Sweden and USA.J Glaucoma1998; 7: 95–104.
4.
KrupinT., SingerP.R., PerlmutterJ., KolkerA.E., BeckerB.. One hour intraocular pressure response to timolol: lack of correlation with long-term response.Arch Ophthalmol1981: 99: 840–1.
5.
BogerW.P.. Timolol: short-term escape and long-term drift.Ann Ophthalmol1979; 11: 1239–42.
6.
GandolfiS.A., VecchiM.. Serial administration of adrenergic antagonists and agonists (‘pulsatile therapy’) reduces the incidence of long term drift to timolol in humans.Invest Ophthalmol Vis Sci1996; 37: 684–8.
7.
Levobunolol Study Group.Levobunolol: a 4-year study of efficacy and safety in glaucoma treatment.Ophthalmology1989; 96: 642–5.
8.
KonstasA.G., MaltezosA.G., GandiS., HudginsA.C., StewartW.C.. Comparison of 24-hour intraocular pressure reduction with two dosing regimens of latanoprost and timolol maleate in patients with primary open-angle glaucoma.Am J Ophthalmol1999; 128: 15–20.
9.
OlatejuS.O., AjayiA.A.. The lack of efficacy of topical beta-blockers, timolol and betaxolol on intraocular pressure in Nigerian healthy volunteers.Eye1999; 13: 758–63.
10.
CoakesR.L., BrubakerR.F.. The mechanism of timolol in lowering intraocular pressure.Arch Ophthalmol1978; 96: 2045–8.
11.
DaileyR.A., BrubakerR.F., BourneW.M.. The effects of timolol, maleate and acetazolamide on the rate of aqueous formation in normal human subjects.Am J Ophthalmol1982; 93: 232–7.
12.
TsukaharaS., SasakiT.. Postural changes of intraocular pressure in normal persons and in patients with primary open angle glaucoma and low-tension glaucoma.Br J Ophthalmol1984; 68: 389–92.
13.
StewartW.C., CateE.A., StewartJ.A.. Systemic beta-blockade with once daily Betimol or Timoptic-XE.J Ocul Pharmacol Ther1999; 15: 225–31.
14.
Van BuskirkE.M.. Adverse reactions from timolol administration.Ophthalmology1980; 87: 447–50.
15.
DiggoryP., Cassels-BrownA., VailA., AbbeyL.M., HillmanJ.S.. Avoiding unsuspected respiratory side-effects of topical timolol with cardioselective or sympathomimetic agents.Lancet1995; 345: 1604–6.
16.
GandolfiS.A., ChettaA., CiminoL.. Increased bronchial reactivity upon long term treatment with topical beta-blockers in human glaucoma.Invest Ophthalmol Vis Sci1999; 40(suppl): S185.