To estimate the clinical efficacy of a newly developed beta1 and beta2 - adrenoreceptor antagonist, levobunolol hydrochloride (Betagan), fifty six patients (96 eyes) with various types of glaucoma were enrolled in this study and were treated twice a day with 0.5% Betagan. Intraocular pressure (lOP), visual acuity, pupil size and cup/disc ratio were measured before and after Betagan treatment, at week 1, 2, 4, 8 and 12. The patients were also examined to check the subjective or objective local adverse reactions. All the patients showed significant reduction of lOP throughout the observation period without significant change of visual acuity, pupil size and cup/disc ratio. Additive hypotensive effect of Betagan was also noted when it was added to pilocarpine. In some patients, however, stinging sensation with tearing, photophobia, or foreign body sensation and punctate corneal erosion were noted after Betagan treatment; those were mild and transient.
Bites and Stings ; Foreign Bodies ; Glaucoma ; Humans ; Intraocular Pressure ; Levobunolol* ; Photophobia ; Pilocarpine ; Pupil ; Sensation ; Tears ; Visual Acuity

The diurnal variation of introcular pressure was measured in 40 eyes of 20 healthy Koreans and in 50 eyes of 25 patients with chronic open angle glaucoma and ocular hypertension with and without levobunolol and dipivefrine. The intraocular pressure was measured every 1 hour from 8:00 o'clock by the same examiner using with Goldmann applanation tonometry. The levobunolol, a new beta-adrenoceptor antagonist effective in the long-term treatment of glaucoma and the dipivefrine, a prodrug of epinephrine which is alpha-and beta-adrenergic agonist, both decrease intraocular pressure despite of opposite pharmacologic actions. Several clinical studies have demonstrated additional effect when an epinephrine compound is added to timolol, a beta-blocker antagonist, theraphy. It is the most important issue that determination of the time of instillatiolt related to the time of maximum effec: of the drugs and the time of the highest intraocular pressure in a day in every each patient. The authors obtained the following results; 1) In the control group, the mean intraocular pressure was 15.3 +/- 1.377 mmHg, the highest was 17.3 +/- 0.924 mmHg at 10 o'clock AM and the lowest was 13.7 +/- 1.764 mmHg at 3 o'clock PM. The diurnal variation was 3.60 +/- 1.743 mmHg.(p=0.002). 2) In the patient group, the mean intracular pressure was 28.5 +/- 1.606 mmHg, the highest was 31.4 +/- 2.986 mmHg at 10 o'clock AM and the lowest was 26.1 +/- 0.836 mmHg at 4 o'clock PM. The diurnal variation was 5.31 +/- 1.101 mmHg.(p=0.0001). 2) The lowering effect of intraocular pressure by the instillation of 0.5% levabunolol and 0.1% dipivefrine was statistically significant(p=0.0001) both in the control group and patient group. In the patient group, the maximum effect was made at 5 hours after instillation of the drugs with 28% decrease. 4) The distribution of the highest intraocular pressure in the patient group was as following: 23 eyes at 10 o'clock AM, 11 eyes at 9 AM, 9 eyes at 11 AM, 3 eyes at 8 AM, 3 eyes at noon and 1 eye at 4 o'clock PM.
Adrenergic beta-Agonists ; Epinephrine ; Glaucoma ; Glaucoma, Open-Angle* ; Humans ; Intraocular Pressure ; Levobunolol* ; Manometry ; Ocular Hypertension ; Pharmacologic Actions ; Timolol

Color Doppler imaging (CDI) was carried out to evaluate the effects of anti-glaucoma drugs on ophthalmic circulation using CDI-derived resistive index (RI) values. CDI was performed on nine Beagle dogs, and RI values were calculated for the medial long posterior ciliary artery before and after the administration of anti-glaucoma drugs. A significant increase in RI values was found after topical administration of levobunolol (p < 0.05) or dipivefrin (p < 0.05). Pilocarpine showed no effects on RI values after topical administration. The results suggest that some anti-glaucoma drugs could affect ophthalmic blood flow.
Adrenergic Agonists/pharmacology ; Animals ; Ciliary Arteries/*drug effects/*ultra ; Dogs ; Epinephrine/analogs & derivatives/therapeutic use ; Eye/*blood supply ; Female ; Glaucoma/*drug therapy ; Levobunolol/therapeutic use ; Male ; Ocular Physiological Phenomena ; Pilocarpine/therapeutic use ; Ultra ; *Vascular Resistance