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The effectiveness and safety of topical dorzolamide in pediatric patients
Few children between the ages of 1 and 6 suffered side effects in a study assessing the effectiveness and safety of topical dorzolamide.
The controlled, randomized, double-masked clinical trial included 122 patients; 56 of whom were younger than 2 years, and 66 subjects were between 2- and 6-years-old. The patients received either dorzolamide 2 percent t.i.d. or timolol maleate gel-forming solution (0.25 percent or 0.5 percent for younger or older patients respectively) q.i.d. and placebo b.i.d. Only 3 patients discontinued the use of dorzolamide due to adverse experience: 1 child developed bradycardia, and 2 others experienced ocular side effects. These side effects most commonly included discharge and hyperemia in the younger cohort and burning or stinging in the older cohort.
After 12 weeks of treatment, dorzolamide lowered intraocular pressure (IOP) by an average of 7.3 mm Hg in younger patients and 7.1 mm Hg in older patients (P<.001 in both cohorts). The dorzolamide drops given 3 times daily had a similar IOP-lowering effect as the timolol given q.d. to a group of children younger than 2 years and another group of children older than 2 years. It is difficult to draw firm conclusions from this study due to the limited number of patients and because of the difficulties in obtaining accurate IOP measurements in this age group. Despite the fact that dorzolamide seems to effectively lower IOP in this age group, the management of childhood (particularly infantile) glaucoma is still mainly surgical (e.g., goniotomy, trabeculotomy, etc).