Interaction with therapeutic soft contact lenses affects the intraocular efficacy of tropicamide and latanoprost in dogs

Mucoadhesive Polymers Enhance Ocular Drug Delivery: Proof of Concept Study with 0.5% Tropicamide in Dogs

Purpose: To assess the efficacy of 0.5% tropicamide applied after topical administration of 1.4% hydroxyethyl cellulose (HEC) or 1.2% hyaluronic acid (HA) at different time intervals. Methods: Eleven healthy Labrador retriever dogs were used. The study consisted of 7 trials in which pupil diameter (PD) was measured every 30 min for 7 h after drug administration. In trial 1, PD was measured after tropicamide application (control). In trials 2-7, PD was measured after treatment with tropicamide 10 s, 1 and 5 min after application of HEC or HA. Data were analyzed using analysis of variance and post hoc Holm-Sidak tests. Results: Maximal PD (mean ± standard deviation) was significantly greater (P < 0.001) in 5 of 6 experimental trials, with the greatest PD recorded when HEC was applied 1 min (12.2 ± 0.4 mm) and HA 10 s (12.3 ± 0.5 mm) before tropicamide, compared with 11.2 ± 0. 7 mm in control trial 1. PD >10 mm was maintained for 2.75-5 h in trials 2-7 and 2.25 h in trial 1 (P < 0.001). Area under the PD-time curve ranged from 61.9 to 71.3 ± 2.9 mm·hours in trials 2-7, significantly greater than 59.3 ± 1.8 mm·hours in control trial 1 (P ≤ 0.031). Conclusions: Tropicamide efficacy was enhanced by prior administration of a mucoadhesive polymer. Additional studies are needed to determine if HEC and HA of varying concentrations similarly extend and potentiate the effect of other topical ophthalmic drugs in canine eyes.

Is it necessary to wait several minutes between applications of different topical ophthalmic solutions? A preliminary study with tropicamide eye drops in healthy dogs

OBJECTIVE

To evaluate the efficacy of topical tropicamide when placed at different time intervals before or after a saline drop.

ANIMALS STUDIED

Eight healthy Labrador and golden retriever dogs.

PROCEDURES

The effect of 1% tropicamide on pupillary diameter (PD) was measured over 240 min when administered alone (control) and then 1 and 5 min prior to, or following, application of a saline drop, with 1-week washout between each of the five trials. Data were analyzed using repeated-measures ANOVA and Tukey post hoc test.

RESULTS

Only 6/110 pairwise comparisons among the 5 trials were statistically significant (p ≤ .035), with post-hoc analysis showing no significant differences (p ≥ .14) between the overall means of all trials. In all five trials, maximal PD was reached 30 min after tropicamide application and maintained until 210 min for 180 min (p = .0005).

CONCLUSIONS

Our results suggest that waiting 1 min between applications of different ophthalmic solutions may be sufficient for maximal drug effect. Care should be taken when extrapolating these results to other species and different ophthalmic formulations.

Albumin Levels in Tear Film Modulate the Bioavailability of Medically-Relevant Topical Drugs

The breakdown of blood-tear barrier that occurs with ocular pathology allows for large amounts of albumin to leak into the tear fluid. This process likely represents an important restriction to drug absorption in ophthalmology, as only the unbound drug is transported across the ocular tissue barriers to exert its pharmacologic effect. We aimed to investigate the effects of albumin levels in tears on the bioavailability of two commonly used ophthalmic drugs: tropicamide, an antimuscarinic that produces mydriasis and cycloplegia, and latanoprost, a PGF2α analog used for the treatment of glaucoma. Eight female beagle dogs underwent a randomized, vehicle-controlled crossover trial. For each dog, one eye received 30 µl of artificial tears (control) or canine albumin (0.4 or 1.5%) at random, immediately followed by 30 µl of 1% tropicamide (2 days, 24 h washout) or 0.005% latanoprost (2 days, 72 h washout) in both eyes. Pupil diameter (digital caliper) and intraocular pressure (IOP; rebound tonometry) were recorded at various times following drug administration (0 to 480 min) and compared between both groups with a mixed model for repeated measures. Albumin in tears had a significant impact on pupillary diameter for both tropicamide (P ≤ 0.001) and latanoprost (P ≤ 0.047), with no differences noted between 0.4% and 1.5% concentrations. Reduction in the maximal effect (pupil size) and overall drug exposure (area under the effect time-curve of pupil size over time) were significant for tropicamide (6.2–8.5% on average, P ≤ 0.006) but not for latanoprost (P ≥ 0.663). The IOP, only measured in eyes receiving latanoprost, was not significantly impacted by the addition of either 0.4% (P = 0.242) or 1.5% albumin (P = 0.879). Albumin in tear film, previously shown to leak from the conjunctival vasculature in diseased eyes, may bind to topically administered drugs and reduces their intraocular penetration and bioavailability. Further investigations in clinical patients and other commonly used ophthalmic medications are warranted.

Changes in intraocular pressure and horizontal pupil diameter during use of topical mydriatics in the canine eye

The objective of this study was to determine the effects of topical 0.5% tropicamide, 1% atropine sulphate and 10% phenylephrine hydrochloride ophthalmic solutions on intraocular pressure (IOP) and horizontal pupil diameter (HPD) in the dog during the first hour after treatment. Forty clinically and ophthalmologically normal canine patients (between the ages of 2 and 6 years) of varying breed and sex were used in this study. Animals were randomly divided into four groups of ten and given one drop of tropicamide, atropine, phenylephrine or saline into one eye. IOP and HPD were measured in both eyes every 5 minutes for 60 minutes. Tropicamide increased IOP by 8.8±4.0 mmHg 35 minutes post-treatment compared to pre-treatment (P<0.01) only in treated eye. IOP in the contralateral eye did not increase. With atropine the maximum increase in IOP was 2.6±2.8 mmHg at 20 minutes post treatment in the treated eye (P<0.01). IOP in the contralateral eye did not increase. Phenylephrine increased IOP by 2.3±2.1 mmHg (P<0.05) 10 minutes after treatment. Also in the untreated eye IOP increased by 2.3±2.1 mmHg, 20 minutes post-treatment. Maximum HPD in eyes treated with tropicamide occurred at 55 minutes and with atropine at 60 minutes. There were no HPD changes in the contralateral, untreated eye. Topical 10% phenylephrine showed maximal pupil dilation 60 minutes after treatment, but the HPD of the – untreated eye slightly decreased at 15 minutes, but this change only reached statistical significance at 40 min post- treatment (P<0.05). Normal saline showed no influence on IOP or HPD. The drugs investigated here show a significant increase in IOP after mydriatics.