A Comparative Clinical Study of Effects of Monotherapy with Oral Captopril and Lisinopril on Intraocular Pressure of Glaucomatous Patients
karbala journal of pharmaceutical sciences,
Volume 3, Issue 3, Pages 1-13
AbstractBackground: Angiotensin I-converting enzyme (ACE) activity has been demonstrated in aqueous humor and other ocular tissues. Coincidence of glaucoma with hypertension or heart failure, the main indications of ACE inhibitors is not uncommon particularly in adults.
Aim of Study is to explore the initial response of intraocular pressure (IOP) to short courses of oral captopril and lisinopril in both normal volunteers and glaucomatous patients.
Patients & Methods: This study included 60 subjects with normal blood pressure whom assigned to receive either captopril tablets (12.5 mg twice daily) or lisinopril tablets (10 mg once daily) for 4 successive days. Each group included 15 volunteers (with normal IOP) and 15 glaucomatous patients (with open angle glaucoma). IOP and blood pressure were measured at pre-treatment, and then after 1, 3, and 4 days of treatment.
Results: Captopril-induced decrement in mean IOP of normal volunteers was highly significant with percentages ranged 4.1-6.6 % (right eyes) and 0.4-4.6 % (left eyes). Percentages of decline in mean IOP of glaucomatous patients ranged from 3.7-7.4 % (right eyes) and 1-9.2 % (left eyes) but statistically, such decrements were variable in significances along the days of captopril treatment.
Lisinopril-induced decrement in mean IOP of normal volunteers was found statistically variable in significances with percentages ranged 3.2-8.9 % (right eyes) and 1.7-5 % (left eyes). Although it was statistically variable in glaucomatous patients' right eyes with percentage ranged from 1.4-6.3 %, the decline in mean IOP of their left eyes was highly significant throughout the trial period and its percentage ranged 4.7-8.7 %.
Conclusions: Each of oral captopril and lisinopril has an initial ocular hypotensive effect and thus might be preferred in treatment of patients with arterial hypertension who are vulnerable to or with raised IOP.
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