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Brimonidine proved safe, effective for reducing ocular redness
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Instillation of brimonidine 0.025% proved to be safe and effective in reducing ocular redness of undetermined nature in eyes with no other specific ocular conditions.
The effect of each instillation lasted for 8 hours, and there was no evidence of tachyphylaxis over 1 month of treatment or rebound redness upon discontinuation, according to a study.
Brimonidine tartrate is a selective imidazoline 2-adrenergic receptor agonist currently used in the treatment of ocular hypertension. As a topical gel, it is also approved as a vasoconstrictor for the treatment of skin rosacea. Like other currently used decongestants, brimonidine reduces ocular redness through vasoconstriction, but may be more reliable for long-term use because of the decreased potential for tachyphylaxis and rebound redness.
To confirm this assumption, a phase 3, randomized clinical trial was conducted. Sixty patients were randomized two to one to receive either brimonidine treatment or vehicle. Conjunctival “blanching” was assessed at various time points after onsite instillation and during 1 month in which subjects were asked to instill the drops four times a day.
At all the time points over the 5- to 240-minute post-instillation period, ocular redness, measured with the Ora Calibra Ocular Hyperemia Scale, showed a significantly greater decrease from baseline in the brimonidine-treated eyes. Redness reduction was maintained over the entire treatment period.
No serious complications occurred. Four subjects reported mild to moderate discomfort, including pruritus, foreign body sensation, increased lacrimation and pain. Minimum redness rebound was observed after discontinuation of the treatment.
“There is an unmet need for a topical vasoconstrictor that can be safely used for long periods for reduction of conjunctival hyperemia,” the authors wrote. “Brimonidine 0.025% looks like a promising option for long-term relief of ocular redness.” – by Michela Cimberle
Disclosure: McLaurin has received research grants from Aciex, Acucela, Alcon Research Ltd., Allergan, AstraZeneca, Bausch + Lomb, Inotek Pharma, InSite Vision, Lexicon Pharma, Mimetogen and Ocular Therapeutix. Please see the study for the other authors’ financial disclosures.
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