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R.F. Brubaker, J. McLaren, D. Herman, C. Nau, L. Wayman, P. Dionisio, M.G. Ciarniello, M.T. Rosignoli; Effect of Ibopamine on Aqueous Humor Flow in Normal Human Eyes . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3432.
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Purpose: Ibopamine is a prodrug of epinine (deoxyepinephrine) that exhibits activity at dopaminergic and adrenergic receptors. It has been shown to cause mydriasis without cycloplegia (1) and to increase the rate of aqueous humor flow in normotensive human eyes. It is known that mydriasis can interfere with the measurement of aqueous flow. For this reason a study was undertaken to remeasure ibopamine’s effect under conditions where mydriasis was controlled. Methods: Twenty-four healthy blue-eyed Caucasian subjects were studied in a randomized, double-masked, paired-comparison, crossover study. Tropicamide was used as a positive mydriatic control and dapiprazole was used as a mydriatic antagonist. Aqueous flow was calculated from the rate of disappearance of topically applied fluorescein. Results: When ibopamine was given alone, the calculated rate of aqueous flow peaked at 7.77 ± 1.02 µl/min (mean ± SE) compared to a rate of 2.82 + 0.11 µl/min when placebo was given, an increase of 176%. When the mydriatic effect of ibopamine was blocked with dapiprazole, the calculated rate of aqueous flow was 3.09 ± 0.09 µl/min compared to a tropicamide-dapiprazol control rate of 2.74 ± 0.09 µl/min, an increase of 13% (p<0.001). Conclusions: We interpreted the very large increase in the rate of clearance of fluorescein in the ibopamine treated eye to be due mainly to loss of fluorescein to the posterior chamber through the uncyclopleged, dilated pupil. We interpreted the 13% increase in clearance of fluorescein in the ibopamine-dapiprazole treated eye to be a real effect of ibopamine on the rate of aqueous humor flow. Ibopamine appears to be among a small group of drugs that stimulate the rate of aqueous humor flow. (1)Virno M, Taverniti L, Motolese E, Taloni M, Bruni P, Pecori Giraldi J. Ibopamina: nuovo midriatico non cicloplegico (nota preliminare). Boll Ocul 1986; 65(11,12): 1135-46
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