The purpose of this paper is to collect the comparative data regarding the actions of Diamox and Neptazane in short-term and long-term administrations.
This investigations were divided into three parts;. (1) a single dose response in normal and glaucomatous eyes, (2) actions on aqueous flow and (3) long-term treatments in glaucomatous eyes.
(I) A single dose response.
Ten eyes from 10 normal subjects, ages ranging from 24 to 57 years, were chosen. They were given 500mg of Diamox or 100mg of Neptazane alternately and intra-ocular pressure was determined at regular intervals.
In another series, 18 eyes from 18 glaucomatous. patients were investigated in the same manner. The patients comprise 13 cases of chronic simple glaucoma and 5 cases of chronic narrow-angle glaucoma. No considerations were given as to their sex and age differences.
Prior to administration of the drugs; the diurnal variations. of intraocular pressure in each eye had been recorded during the daytime. The intra-ocular pressure was measured by Goldmann´s applanation tonometer.
(II) Actions on aqueous flow.
Actions of Diamox (500mg) and. Neptazane (100mg) on the aqueous flow were studied by the perilimbal suction cup method of Rosengren and Ericson in 8 normal eyes. The suction cup was applied 3 hours after Diamox and 6 hours after Neptazane administration.
(III) Long-term treatments.
Fifteen glaucomatous patients, 10 chronic simple glaucoma and 5 chronic narrow-angle glaucoma, were investigated. Their ages were from 43 to 61 years. The schedules of dosage were 250mg of Diamox, t.i.d. or 50mg of Neptazane, t.i.d. and followed up to 35 days. In some cases, treatment was discontinued or the doses were reduced to 250mg of Diamox, b.i.d. and 50mg. of Neptazane, b.i.d., due to the side reactions.
Results
( I) Results of measurements of -intra-ocular pressure in normal eyes were shown in Table 1 and 2.
(a) Diamox: The ocular tension begins to fall as early as 30 minutes,and maximal lowering occurred between 1~4 hours (average, 2.3 hours). Thereafter, tensions rose again and returned to the signal level within 24 hours in all cases except in 2 cases. The maximal reduction was on the rage 3.7mmHg. Side reactions were observed in 3 cases.
(b) Neptazane: The tention begins to fall 0. 5~1 hour and the maximal fall was observed between -8 hours (average, 6.4 hours). The maximal degree of fall was 3.3 mmHg. The ocular pressure as still low after 24 hours in all cases except in 3 cases. No side reaction was encountered.
(B) In glaucomatous eyes: Results were summarized in Table 3 & 4.
(a) Diamox:
Ocular tension begins to fall 30 minutes and maximal fall was attained at 2.2 hours. The degree maximal reduction was 13.7 mmHg. The lowered tension returned to the initial level within 24 hours in most cases. Side reactions were observed in 5 cases.
(b) Neptazane:
Ocular tension begins to fall 0.5~1 hour and maximum lowering was observed after 6 hours. The extent of maximal fall was 12.3 mmHg. The ocular tension was still low after 24 hours in most cases de reactions were encountered in 3 cases.
(II) Perilimbal suction cup studies revealed that both Diamox and Neptazane reduced the aqueous )w considerably as shown in table 5.
(III) Results of long-term treatments were tabulated in table 6 and 7.
(a) Diamox: The maximal degrees of fall in ocular tension were observed relatively early in the treatment and thereafter the tension fluctuates irregularly and showed tendencies to gradual rises de effects were observed in 10 cases. Complete normalization of ocular tension, e.g., under 21 mHg, was achieved in 8 cases.
(b) Neptazane: The same tendency was observed in this group. Side reactions were encountered 6 cases and milder than in Diamox treated group.
As these results show, both Diamox and Neptazane showed a significant tension lowering effect, eptazane is five times more powerful than Diamox in equal dosage basis. The ocular pressure falls ore slowly and its duration was longer in Neptazane treated eyes. Side reactions were observed ore frequently in Diamox group and somewhat severe.
|