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A Journal on Ophthalmology
Minerva Oftalmologica 2001 March-June;43(1-2):5-10
Intraocular pressure and ß-blockers
Rossi S., Di Filippo C., Mazzeo F., Capuano A., D'Amico M.
Beta-blockers are the most used drugs for treatment of glaucoma. They have some advantages such as the rate of administration (e.g. once or twice daily), the route of administration (e.g. topical), and a relative low incidence of adverse reactions with exception of asthmatic or cardiopathic patients. Timolol is the commonly used beta-blocker. Its topical administration is frequently recommended as first-line therapy in the treatment of glaucoma. It represents the reference agent against which other medications are measured in terms of efficacy, side effects and cost. Clinical trials show that the administration of timolol to patients undergoing to multiple antiglaucomatose therapy further reduce the intraocular pressure as it is for example the association of timolol and the carbonic anhydrase inhibitor dorzolamide. Although timolol represents the first choice in the treatment of glaucoma, its topical administration can cause serious side effects which limit the use. Indeed, topical therapy with timolol is contraindicate in asthmatics, patients with bradycardia, atrioventricular block and patients with heart failure. Betaxolol, together with carteolol, levobunolol and metipranolol are newly approved beta-blockers for treatment of glaucoma.