TIPOLOGIA DEGLI EFFETTI COLLATERALI DA FARMACI ANTIGLAUCOMATOSI TOPICI

A retrospective investigation has examined the frequency of both topical and systemic side-effects provoked: by the topical administration of different classes of antiglaucomatous drugs in 720 patients with both high snd low-tension glaucoma. Observation time was from 6 to 24 years. The drugs used were parasympathomimetics (120 patients), beta-blockers (338 patients), a2-agonists (66 patients), topical carbonic anhydrase inhibitors (55 patients) and prostaglandin analogs (242 patients). 0n the basis of the results obtained, the most frequent topical side-effect observed with parasympathomimetics was ocular pain (7.75%). Beta-blockers were shown to have a very good both topical and systemic tolerance in the longest period of observation (18 years). With a2-agonists a frequency of 7.57% of conjunctival hyperemia was reported, which can be attributed to the reactive vasodilatation following the vasoconstriction provoked by the stimulation of a 2-receptors. By using the CAl's a rather high frequency of conjunctival hyperemia (21%) and foreign body sensation (16%) was demonstrated. Moreover, in 17.3% of the patients systemic side-effects such as cephalea, generalized dermatitis, asthenia and kidney pain were reported. The most frequent topical side-effect observed with prostaglandin analogs was conjunctival hyperemia (9.85%) followed by megalotrichiasis (7%). The latter was shown to stabilize after the first year of treatment. In conclusion the tolerance to the different antiglaucomatous drugs depends chiefly on the individual characteristics of the patients and, once more, it is confirmed that the treatment should be appropriate and specific for each patient.