Journal of the Korean Ophthalmological Society 1966;7(1):15-18.
Clinical Experiences with Sustained-Relase Diamox Sequels.
Won Shik Youn, Jae Myong Kim, Bong Leen Chang
Department of Ophthalmology, School of Medicine, Seoul National University, Seoul, Korea.
Diamox Sequls의 임상경험 (臨床經驗)
윤원식(Won Sik Yoon),장봉린(Bong Leen Chagn),김재명(Jae Myung Kim)
Abstract
The tension lowering effects of Diamox and other carbonic anhydrase inhibitors are well known and they are widely used against a various forms of glaucomas. This paper deals with the clinical experiences in normal and glaucomatous human eyes with Diamox-Sequels, kindly supplied by Lederle Laboratories and Yuhan Corp. MATERIALS AND METHODS: Normal healthy persons, 15 females and 20 males, were studied on their 45 eyes. Glaucomatous disease had been ruled out by careful examinations of intraocular pressure, visual fields and fundus. They had been also checked for the diurnal variations of intraocular pressure during the daytime. One capsule (500mg) of Diamox Sequels was given to each individual and the changes in the intraocular pressure were studied at various time intervals up to 53 hours after the administration. Tonometry was carried out by the Goldmann's applanation tonometer. The effects of Diamox Sequels on the glaucomatous eyes were studied in the same way. The glaucomatous eyes included 10 eyes of 7 chronic simple glaucoma patients, 5 eyes of 3 chronic narrow-angle glaucoma patients and 5 eyes of 5 secondary glaucoma subjects. They received one capsule of Diamox Sequels and the intraocular pressure was measured one or two times daily. The results of long-term treatment were also studied by daily administration of one capsule of Diamox Sequels, follow-up periods being from 3 to 19 days. No medication, oral or local, of antiglaucomatous drugs were allowed for at least 3 days prior to this study. The differences due to age, sex and type of glaucoma were not considered here. At the same time, the effects of a single 500mg of ordinary Diamox tablet were studied in normal ~md glaucomatous eyes. RESULTS: (1) Normal eyes. The intraocular pressure began to fall 1 hour after the administration. The tension gradually fell and the maximal reduction of tension occurred after 9.8 hours and the extent of maximal fall was 4.5mm Hg on the average, 29.4 % of the original intraocular pressure. The tension gradually rose and returned to the original level between 23~50 hours (average 43 hours). Side effects were noted in 4 cases, e.g., 11.4 %. (2) Glaucomatous eyes. The effects were noted within the first 1~2 hours and became maximal after 13 hours, the extent of the maximal fall 40.1 % of the original pressure, e.g., 16.2 mmHg. The original tension was restored after 30 hours. By long-term administration of Diamox Sequels, 8 eyes(40 %) showed excellent results, their intraocular pressure maintained below 21 mmHg. Sede-effects were noted in 3 cases(20.0 %). COMMENTS: The effects of Diamox Sequels and Diamox tablet on normal and glaucomatous subjects were summarized in table 1. As shown, Diamox Sequels has the longer duration of hypotensive actions and the time of maximal fall of intraocular pressure delayed considerably, as compared with Diamox tablet. In almost all cases, its action continued for more than 24 hours. In glaucomatous eyes, the time of maximal reduction of ocular tension was slightly later and the maintenance of low tension was slightly shorter than those in normal eyes. The extent of the maximal fall, however, was almost the same after administration of Diamox Sequels and Diamox. Side effects were encountered in 11~20% of cases by Diamox Sequels, and in 40-60% of cases by Diamox. This is one of the most striking advantages of Diamox Sequels over Diamox. Thus it is concluded that Diamox Sequels has the longer hypotensive actions and fewer side effects.


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