Journal of Current Glaucoma Practice

Register      Login

VOLUME 8 , ISSUE 1 ( January-April, 2014 ) > List of Articles


Effect of Topical Calcium Channel Blockers on Intraocular Pressure in Steroid-induced Glaucoma

Sunil Ganekal, Syril Dorairaj, Vishal Jhanji, Krishnaprasad Kudlu

Keywords : Calcium channel blockers, Intraocular pressure, Steroid-induced glaucoma

Citation Information : Ganekal S, Dorairaj S, Jhanji V, Kudlu K. Effect of Topical Calcium Channel Blockers on Intraocular Pressure in Steroid-induced Glaucoma. J Curr Glaucoma Pract 2014; 8 (1):15-19.

DOI: 10.5005/jp-journals-10008-1155

License: CC BY-NC 4.0

Published Online: 01-04-2019

Copyright Statement:  Copyright © 2014; The Author(s).


Purpose: To evaluate the effect of 0.125% verapamil and 0.5% diltiazem eye drops on intraocular pressure (IOP) in steroid-induced glaucoma in rabbit eyes. Methods: A total of 18 rabbits with steroid-induced glaucoma were divided into three groups (A, B and C; n = 6 each). Right eyes in groups A, B and C received 0.5% diltiazem, 0.125% verapamil and 0.5% timolol eye drops twice daily for 12 days, respectively; whereas, left eyes received distilled water. IOP was measured with Tono-pen XL at baseline, day 4, day 8, and day 12 of treatment. Results: Both 0.5% diltiazem and 0.125% verapamil eye drops significantly reduced IOP compared to control eyes (p < 0.05). Reduction of IOP by 0.5% diltiazem, 0.125% verapamil eye drops were comparable to 0.5% timolol. No surface toxicity or systemic side effects were noted during the study period. Conclusion: Calcium channel blockers, verapamil, and diltia-zem significantly reduced IOP in rabbiteyes. This group of drugs may have a potential role in treatment of glaucoma

PDF Share
  1. Kumarasamy NA, Lam FS, Wang AL, Theoharides TC. Glaucoma: current and developing concepts of inflammation, pathogenesis and treatment. Eur J Inflamm 2006 Oct;4(3):129-137.
  2. Resnikoff S, Pascolini D, Etya'ale D, Kocur I, Pararajasegaram R, Pokharel GP, Mariotti SP. Global data on visual impairment in the year 2002. Bull World Health Organ 2004 Nov;82(11): 844-851.
  3. Kass MA, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, Parrish RK 2nd, Wilson MR, Gordon MO. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol 2002Jun;120(6):701-713.
  4. Hof RP. Calcium antagonist and peripheral circulation: differences and similarities between PY 108-068, nicardipine, verapamil and diltiazem. Br J Pharmacol 1983 Feb;78(2):375-394.
  5. Ohtsuka M, Yokota M, Kodama I, Yamada K, Shibata S. New generation dihydropyridine calcium entry blockers: in search of greater selectivity for one tissue subtype. Gen Pharmacol 1989;20(5):539-556.
  6. Monica ML, Hesse RJ, Messerli FH. The effect of a calciumchannel blocking agent on intraocular pressure. Am J Ophthalmol 1983 Dec;96(6):814.
  7. Abelson MB, Gilbert CM, Smith LM. Sustained reduction of intraocular pressure in humans with the calcium channel blocker verapamil. Am J Ophthalmol 1988 Feb;105(2):155-159.
  8. Goyal JK, Khilnani G, Sharma DP, Singh J. The hypotensive effect of verapamil eye drops on ocular hypertension. Indian J Ophthalmol 1989 Oct-Dec;37(4):176-178.
  9. Roth M, Eickelberg O, Kohler E, Erne P, Block LH. Ca2+ channel blockers modulate metabolism of collagens within the extracellular matrix. Proc Natl Acad Sci USA 1996 May;93(11):5478-5482.
  10. Erickson KA, Schroeder A, Netland PA. Verapamil increases facility of outflow in the human eye. Exp Eye Res 1995 Nov;61(5):565-567.
  11. Podos SM. The effect of cation ionophores on intraocular pressure. Invest Ophthalmol 1976 Oct;15(10):851-854.
  12. Green K, Kim K. Papaverine and verapamil interaction with prostaglandin E2 and (delta) 9-Tetrahydrocannabinol in the eye. Exp Eye Res 1977;24(2):207-212.
  13. Shayegan MR, Boloorian AA, Kianoush S. Comparative study of topical application of timolol and verapamil in patients with glaucoma within 6 months. J Ocul Pharmacol Ther 2009 Dec;25(6):551-553.
  14. Braunwald E. Mechanism of action of calcium-channel- blocking agents. N Engl J Med 1982 Dec;307(26):1618-1627.
  15. Abernethy DR, Schwartz JB. Calcium-antagonist drugs. N Engl J Med 1999 Nov;341(19):1447-1457.
  16. Eisenberg MJ, Brox A, Bestawros AN. Calcium channel blockers: an update. Am J Med 2004 Jan;116(1):35-43.
  17. Montanari P, Marangoni P, Oldani A, Ratiglia R, Raiteri M, Berardinelli L. Color Doppler imaging study in patients with primary open-angle glaucoma treated with timolol 0.5% and carteolol 2%. Eur J Ophthalmol 2001 Jul-Sep;11(3): 240-244.
  18. Dettmann ES, Lüscher TF, Flammer J, Haefliger IO. Modulation of endothelin-1-induced contractions by magnesium/calcium in porcine ciliary arteries. Graefes Arch Clin Exp Ophthalmol 1998 Jan;236(1):47-51.
  19. Gaspar AZ, Flammer J, Hendrickson P. Influence of nifedipine on the visual fields of patients with optic-nerve-head diseases. Eur J Ophthalmol 1994 Jan-Mar;4(1):24-28.
  20. Gaspar AZ, Gasser P, Flammer J. The influence of magnesium on visual field and peripheral vasospasm in glaucoma. Ophthalmologica 1995;209(1):11-13.
  21. Gasser P, Flammer J. Short- and long-term effect of nifedipine on the visual field in patients with presumed vasospasm. J Int Med Res 1990 Jul-Aug;18(4):334-339.
  22. Beatty JF, Krupin T, Nichols PF, Becker B. Elevation of intraocular pressure by calcium channel blockers. Arch Ophthalmol 1984 Jul;102(7):1072-1076.
  23. Melena J, Santafé J, Segarra J. The effect of topical diltiazem on the intraocular pressure in betamethasone-induced ocular hypertensive rabbits. J Pharmacol Exp Ther 1998 Jan;284(1):278-282.
  24. Segarra J, Santafé J, Garrido M, Martinez de Ibarreta MJ. The topical application of verapamil and nifedipine lowers intraocular pressure in conscious rabbits. Gen Pharmacol 1993 Sep;24(5):1163-1171.
  25. Siegner SW, Netland PA, Schroeder A, Erickson KA. Effect of calcium channel blockers alone and in combination with antiglaucoma medications on intraocular pressure in the primate eye. J Glaucoma 2000 Aug;9(4):334-339.
  26. Netland PA, Grosskreutz CL, Feke GT, Hart LJ. Color Doppler ultrasound analysis of ocular circulation after topical calcium channel blocker. Am J Ophthalmol 1995 Jun;119(6): 694-700.
  27. Kelly SP, Walley TJ. Effect of the calcium antagonist nifedipine on intraocular pressure in normal subjects. Br J Ophthalmol 1988 Mar;72(3):216-218
  28. Brubaker RF. The physiology of aqueous humor formation. In: Drance SM, Neufeld AH, editors. Glaucoma: Applied Pharmacology in Medical Treatment. Orlando: Grune and Stratton, Inc; 1984. p. 35-70.
  29. Harino S, Riva CE, Petrig BL. Intravenous nicardipine in cats increases optic nerve head but not retinal blood flow. Invest Ophthalmol Vis Sci 1992 Sep;33(10):2885-2890.
  30. Kohzuka T. Vasodilative effect of nicardipine hydrochloride on rabbit retinal microcirculation in vivo. Folia Ophthalmol Jpn 1984;35:877-882.
  31. Nielson PJ, Nyborg NC. Calcium antagonist-induced relaxation of the prostaglandin-F2 alpha response of isolated calf retinal resistance arteries. Exp Eye Res 1989 Mar;48(3): 329-335.
  32. Mikheytseva IN, Kashintseva LT, Krizhanovsky GN, Kopp OP, Lipovetskaya EM. The influence of the calcium channel blocker verapamil on experimental glaucoma. Int Ophthalmol 2004 Mar;25(2):75-79.
  33. Hiroishi G, Kobayashi S, Nishimura J, Inomata H, Kanaide H. Differential effects of diltiazem and nitroglycerin on cytosolic Ca2+ concentration and on force in the bovine ophthalmic artery. Invest Ophthalmol Vis Sci 1996 Dec;37(13):2612-2623.
  34. Santafé J, Martínez de Ibarreta MJ, Segarra J, Melena J. A longlasting hypotensive effect of topical diltiazem on the intraocular pressure in conscious rabbits. Naunyn-Schmiedebergs Arch Pharmacol 1997 May;355(5):645-650.
  35. Yu DY, Su EN, Cringle SJ, Alder VA, Yu PK, DeSantis L. Systemic and ocular vascular roles of the antiglaucoma agents beta-adrenergic antagonists and Ca2+ entry blockers. Surv Ophthalmol 1999 Jun;43 Suppl 1:214S-222S.
  36. Payne LJ, Slagle TM, Cheeks LT, Green K. Effect of calcium channel blockers on intraocular pressure. Ophthalmic Res 1990;22(6):337-341.
  37. Sears M, Caprioli J, Kazuyoshi K, Bauscher L. A mechanism for the control of aqueous humor formation. In: Drance SM, Neufeld AH. Glaucoma: Applied Pharmacology in Medical treatment. Orlando: Grune and Stratton, Inc; 1984. p. 303-324.
  38. Erickson KA, Schroeder A, Netland PA. Verapamil increases outflow facility in the human eye. Exp Eye Res 1995 Nov;61(5):565-567.
  39. Mooshian ML, Leonardi LM, Schooley GL, Erickson K, Greiner JV. One-drop study to evaluate safety and efficacy of an ophthalmic calcium channel blocker, verapamil, in subjects with elevated intraocular pressure. Invest Ophthalmol Vis Sci 1993;34:924.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.