The Predicting Glaucoma Development Project: Examining the utility of an Ibopamine challenge test to predict glaucoma development in glaucoma suspects.
A study to examine the utility of an Ibopamine challenge test, to predict who might develop glaucoma from those patients who are glaucoma suspects.
John Landers
100 participants
Sep 1, 2015
Interventional
Conditions
Summary
It’s a clinical trial of a drug called Ibopamine, to be used in a challenge test in much the same way as a water drinking test. Ibopamine is an alpha, beta and dopamine receptor agonist, which causes a brief increase in aqueous production for about 4 hours after a single drop. Among normal patients, this causes no change in intraocular pressure, but in glaucoma patients, IOP will increase. My suspicion is that the degree of IOP rise might be related to the patient’s likelihood of further progression in the future. I have recently completed a pilot case-control study which has successfully shown that an ibopamine challenge can differentiate between glaucoma suspects, stable glaucoma patients and patients whose glaucoma is rapidly worsening. Now, I would like to commence a longitudinal study investigating the predictive value of a positive ibopamine challenge among glaucoma suspects and early glaucoma patients.
Eligibility
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Interventions
Intraocular pressure (IOP) is dependent on the balance between the production of aqueous fluid within the eye and the rate at which aqueous leaves the eye through the trabecular meshwork (TM) in the angle of the eye’s anterior chamber. The medication Ibopamine (Trazyl: Pharmainvest SpA, Milano, Italy) which is a dopamine receptor agonist, will temporarily increase aqueous production and dilate the pupil. A healthy eye with healthy TM cells will overcome this increase, pump aqueous out of the eye at an increased rate and the patient will demonstrate no IOP rise when Ibopamine drops are applied topically to the eye, however there is evidence that those with glaucoma will exhibit a rise in IOP. It may be that patients whose glaucoma is progressively worsening, will demonstrate a larger increase in IOP when Ibopamine drops are applied topically to their eye compared with stable patients. To undertake an Ibopamine challenge, the patient has their IOP measured and recorded using goldmann applanation tonometry seated at the slit lamp; they then had two drops of Ibopamine 2% solution instilled into both of their eyes; lastly their IOP is re-measured 45 minutes after receiving the Ibopamine eye drops and the IOP results pre and post the challenge are compared.
Locations(1)
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ACTRN12615000767505