Sturge-Weber Syndrome Medication
- Author: Monte A Del Monte, MD; Chief Editor: Hampton Roy Sr, MD more...
Medication Summary
Medical therapy in patients with Sturge-Weber syndrome involves many agents, including beta blockers, carbonic anhydrase inhibitors, and prostaglandin analogues, that can be used to lower the intraocular pressure. Medical therapy is used as an initial treatment, especially in late-onset glaucoma, with surgical therapy initially used in early onset cases. Aqueous suppressants are typically used for initial medical therapy. Prostaglandin analogues may not be as effective in these patients, because the episcleral venous pressure is often elevated by dilated, tortuous episcleral veins. Corticosteroids are used to reduce inflammation.
Beta Blockers
Class Summary
These agents lower intraocular pressure by decreasing the production of aqueous humor.
Levobunolol 0.25% or 0.5% (Betagan)
This is a nonselective beta-adrenergic blocking agent that lowers intraocular pressure by reducing aqueous humor production
Carbonic Anhydrase Inhibitors
Class Summary
These agents lower intraocular pressure by decreasing aqueous production.
Dorzolamide 2% (Trusopt)
Dorzolamide inhibits carbonic anhydrase in the ciliary processes, which decreases aqueous humor formation.
Brinzolamide 1% (Azopt)
Brinzolamide inhibits carbonic anhydrase in the ciliary processes, which decreases aqueous humor formation.
Prostaglandin Analogues
Class Summary
These agents lower intraocular pressure by increasing aqueous outflow through the uveoscleral pathway.
Latanoprost 0.005% (Xalatan)
Latanoprost may decrease intraocular pressure by increasing the outflow of aqueous humor.
Topical Corticosteroids
Class Summary
These medications are used to treat ocular inflammation.
Prednisolone acetate 1% (Pred Forte, Pred Mild, Omnipred)
This agent inhibits the edema, fibrin deposition, capillary dilation, and phagocytic migration of the acute inflammatory response, as well as capillary proliferation. It causes the induction of phospholipase A2 inhibitory proteins.
Dexamethasone ophthalmic (Maxidex, Ozurdex)
Dexamethasone ophthalmic decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reducing capillary permeability
Triamcinolone (Triesence)
Triamcinolone is used to treat inflammatory reactions that are responsive to steroids. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability.
Antineoplastic Agents
Class Summary
These agents inhibit cell growth and proliferation.
Fluorouracil (Efudex)
Fluorouracil interferes with deoxyribonucleic acid (DNA) synthesis by blocking the methylation of deoxyuridylic acid, inhibiting thymidylate synthetase and, subsequently, cell proliferation
Mitomycin
Mitomycin interferes with DNA synthesis by alkylation and by cross-linking the strands of DNA.
[Guideline] American Association of Neuroscience Nurses. Care of the patient with seizures. 2nd ed. Glenview (IL): American Association of Neuroscience Nurses; 2007.
Govori V, Gjikolli B, Ajvazi H, Morina N. Management of patient with Sturge-Weber syndrome: a case report. Cases J. Dec 23 2009;2:9394. [Medline].
Parsa, CF. Sturge-Weber Syndrome:A Unifified Pathophysiologic Mechanism. Curr Treat Options Neurol. 2008;10:47-54. [Medline].
Eibschitz-Tsimhoni M, Lichter PR, Del Monte MA, et al. Assessing the need for posterior sclerotomy at the time of filtering surgery in patients with Sturge-Weber syndrome. Ophthalmology. Jul 2003;110(7):1361-3. [Medline].
[Best Evidence] [Guideline] Patrianakos TD, Nagao K, Walton DS. Surgical management of glaucoma with the sturge weber syndrome. Int Ophthalmol Clin. 2008;48(2):63-78. [Medline].
Audren F, Abitbol O, Dureau P. Non-penetrating deep sclerectomy for glaucoma associated with Sturge-Weber syndrome. Acta Ophthalmol Scand. Oct 2006;84(5):656-60. [Medline].
Sharan S, Swamy B, Taranath DA, et al. Port-wine vascular malformations and glaucoma risk in Sturge-Weber syndrome. J AAPOS. Aug 2009;13(4):374-8. [Medline].
Print
