Ophthalmic Solution USP, 1%
Dipivefrin Hydrochloride Ophthalmic Solution USP, 0.1% is a sterile, isotonic solution. Dipivefrin hydrochloride is a white, crystalline powder, freely soluble in water.
Dipivefrin hydrochloride ophthalmic solution is indicated as initial therapy for the control of intraocular pressure in chronic open-angle glaucoma. Patients responding inadequately to other antiglaucoma therapy may respond to addition of dipivefrin.
In controlled and open-label studies of glaucoma, dipivefrin demonstrated a statistically significant intraocular pressure lowering effect. Patients using dipivefrin twice daily in studies with mean durations of 76-146 days experienced mean pressure reductions ranging from 20-24%.
Therapeutic response to 0.1% dipivefrin twice daily is somewhat less than 2% epinephrine twice daily. Controlled studies showed statistically significant differences in lowering of intraocular pressure between 0.1% dipivefrin and 2% epinephrine. In controlled studies in patients with a history of epinephrine intolerance, only 3% of patients treated with dipivefrin exhibited intolerance, while 55% of those treated with epinephrine again developed intolerance.
Therapeutic response to 0.1% dipivefrin twice daily is comparable to 2% pilocarpine 4 times daily. In controlled clinical studies comparing 0.1% dipivefrin and 2% pilocarpine, there were no statistically significant differences in the maintenance of IOP levels for the two medications.
Dipivefrin does not produce miosis or accommodative spasm which cholinergic agents are known to produce. The blurred vision and night blindness often associated with miotic agents are not present with dipivefrin therapy. Patients with cataracts avoid the inability to see around lenticular opacities caused by constricted pupil.
Published Studies Related to Dipivefrin (Dipivefrin Ophthalmic)
[Changes in retinal blood flow by topical administration of 0.1% dipivefrin] [1999.11]
PURPOSE: Most of the antiglaucomatous drugs affect ocular blood flow. Blood flow of the anterior uvea under the effect of glaucoma medication has been described in the literature, but measurement of microcirculation at the posterior pole correlated to glaucoma medication is rarely found. We present a placebo-controlled study in which we focused on the short and long-term effects of topical dipivefrine 0.1% on the microcirculation of the retina and optic nerve head... CONCLUSION: Retinal capillary perfusion is affected by dipivefrine 0.1% medication. In neuroprotection, it is of interest that glaucoma medication did not alter the microcirculation in a way that leads to an increase of hypoxemia. Therefore, we consider dipivefrine 0.1% not to be useful for long-term glaucoma treatment.
Effects of dipivefrin and pilocarpine on pupil diameter, automated perimetry and LogMAR acuity. [1999.02]
BACKGROUND: A study was carried out to ascertain, in ophthalmologically normal subjects, the short-term effects of dipivefrin hydrochloride 0.1% on visual performance and make comparisons with pilocarpine... CONCLUSIONS: In normals dipivefrin causes mydriasis but does not affect the central visual field global indices (as assessed by STATPAC), or high- and low-contrast LogMAR acuity. Pilocarpine adversely affects the visual field and both measures of acuity. Knowledge of these effects is of value in glaucoma therapy and when monitoring the progression of visual loss.
Effects of latanoprost and dipivefrin, alone or combined, on intraocular pressure and on blood-aqueous barrier permeability. [1998.04]
AIM: To investigate the effect on intraocular pressure (IOP) and aqueous flare of topical applications of latanoprost and dipivefrin alone or combined... CONCLUSIONS: Latanoprost and dipivefrin have an additive effect on IOP and no clinically significant effect on the permeability to proteins of the blood-aqueous barrier. This implies that the two drugs can be a useful combination for the treatment of glaucoma.
The efficacy of the combination of l-moprolol and dipivefrin in reducing the intraocular pressure in primary open-angle glaucoma or in ocular hypertension. [1994.11]
BACKGROUND: In this double-blind prospective trial the efficacy of lowering the intraocular pressure of l-moprolol given alone and in combination with dipivefrin was tested... CONCLUSION: This trial demonstrated that the combination of l-moprolol and dipivefrin is an effective and safe treatment for elevated intraocular pressure.
Dipivefrin reduces blood flow in the ciliary body in humans. [1994.04]
CONCLUSION: The observed data suggest that dipivefrin decreases ciliary body blood flow.
Clinical Trials Related to Dipivefrin (Dipivefrin Ophthalmic)
Comparison of Functional Vision Provided by AMO Tecnis Z9000 and Alcon SA60AT Acrysof [Recruiting]
This study is to compare intraindividually the functional vision provided by two different
posterior chamber intraocular lenses: AMO Tecnis Z9000 and Alcon SA60AT Acrysoft. To see if
the aspherical intraocular lenses provide better functional vision than traditional
spherical intraocular lenses.
Comparison of the Quality of Vision Provided by AMO Tecnis Z9000 and Alcon Laboratories MA60 Acrysof Posterior Chamber Intraocular Lenses [Recruiting]
Influence of Blue Light Filtering Intraocular Lenses on Daytime Levels of Melatonin [Recruiting]
The "blue light hazard" has been reported to cause retinal damage (oxidative stress),
particularly to the central fovea due to its energetic, shorter wavelength visible photons,
which is why blue-light filtering intraocular lenses have been developed for cataract
surgery. The hormone melatonin has been reported to possess an efficient antioxidant
capacity. Light information from the eye reaches the suprachiasmatic nuclei and inhibits
melatonin secretion. Since melatonin is suppressed by light, we have a day-night rhythmicity,
with increased levels at night. Melatonin suppression is wavelength-dependent with a peak
sensitivity in the 446-477 nm (blue light) portion of the visible spectrum. The crystalline
lens blocks most UV between 300 and 400 nm. The density of the lens increases with aging
causing an alteration in the spectral absorption. The greatest increase in absorption occurs
at the short wavelength end of the spectrum (around 400-470 nm). Age-related pupillary miosis
and crystalline lens yellowing limit the blue light reaching the retina. This reduces the
older adults' effective retinal light exposure to one tenth that of younger people. It has
been shown that insomnia and depression decrease after cataract surgery and patients returned
to youthful levels of melatonin. Since melatonin acts as an antioxidant, and more blue light
filtering intra ocular lenses are implanted and thought to reduce photochemical damage in the
macula, it would be interesting to show the positive influence of those blue light filtering
intraocular lenses on daytime levels of melatonin in age-related macular degeneration
Evaluation of Alcon Ladarvision Wavefront-Guided PRK [Completed]
The purpose of this study is to:
1. determine the safety of wavefront guided PRK
2. evaluate the efficacy of wavefront guided PRK
3. evaluate the differences in visual quality after treatment of wavefront guided PRK
A Prospective Comparison of Alcon LADARVision Wavefront-Guided LASIK Enhancement and Conventional LASIK Enhancement for the Correction of Residual Refractive Errors Following LASIK Procedures [Active, not recruiting]
The purpose of this study is to conduct a prospective clinical trial to compare conventional
and WFG LASIK for enhancements on post-LASIK patients. Differences in safety, efficacy,
visual quality, and refractive stability will also be compared during this study.