Carbonic Anhydrase Inhibitors

Systemic acetazolamide may cause severe systemic side effects including metabolic acidosis, renal problems, and hepatic necrosis. Owing to its chemical structure, acetazolamide should not be given in cases with a sulfonamide allergy. Under controlled circumstances, acetazolamide is sometimes used for short periods, preferably in older children. Topical carbonic anhydrase inhibitors, such as dorzolamide and brinzo-lamide, are less likely to cause side effects than oral acetazolamide, but seem to be less effective in pressure reduction [45]. Little is known about the disturbance of endothelial function in buphthalmic eyes with extensive Haab striae on treatment with topical carbonic anhydrase inhibitors.

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