Effect of topical administration of 0.1% diclofenac sodium ophthalmic solution at four frequencies on intraocular pressure in healthy Beagles

Abstract

OBJECTIVE To evaluate effects of topical ophthalmic administration of diclofenac on intraocular pressure (IOP) when applied at 4 frequencies to eyes of Beagles. ANIMALS 8 ophthalmologically normal Beagles. PROCEDURES The study involved four 5-day experimental periods each separated by a 16-day washout period. During each period, 1 drop of 0.1% diclofenac sodium ophthalmic solution was administered to the right eye at 4 treatment frequencies (1, 2, 3, or 4 times/d); 1 drop of eyewash was administered to the left eye as a control treatment. A complete ophthalmic examination was performed on days 0 (day before first treatment) and 5 of each experimental period. Gonioscopy was performed on day 0 of the first period. The IOPs were measured at 7 am and 7 pm on days 1 through 5. RESULTS No abnormalities were detected during neuro-ophthalmic and ophthalmic examinations on day 0 of each experimental period. No adverse reactions to administration of diclofenac or eyewash were observed at any time point. No abnormalities were detected during ophthalmic examinations performed on day 5, and IOPs remained < 25 mm Hg in all 4 periods. No significant differences were identified between the treated and control eyes or among the 4 treatment frequencies. CONCLUSIONS AND CLINICAL RELEVANCE Topical ophthalmic administration of diclofenac up to 4 times/d in dogs with no ophthalmic abnormalities did not significantly increase the IOP. Additional research is needed to evaluate the effect of topical ophthalmic administration of diclofenac on IOP in dogs with anterior uveitis.

The association of topical flurbiprofen with the incidence of postoperative glaucoma after phacoemulsification in dogs

“…It was previously demonstrated that topical flurbiprofen administration induced a small but statistically significant IOP elevation in normal canine eyes compared with the control eye 18 . A recent study with conflicting results regarding the effect of topically applied NSAIDs on IOPs reported no significant effect of topical administration of diclofenac on IOP in normal canine eyes; nevertheless, the same study suggested the topical administration of NSAIDs in eyes with anterior uveitis and a predisposition to high IOP should be carefully considered 14 . In a human study, preoperative administration of diclofenac did not elevate IOP during the early postoperative period following cataract extraction, but the mean IOP increase was higher in the diclofenac group (11.3 and 9.6 mmHg from the baseline in the diclofenac and placebo group, respectively, at 24 h postoperatively) 20 .…”

“…Intracameral recombinant tPA is known to be effective in lysing postoperative fibrin, and the use of steroids can suppress postoperative inflammation and prevent fibrin formation 21 . Following phacoemulsification surgery, recurrent inflammation and/or severe fibrin formation is associated with anterior or posterior synechiae, pupillary block, and secondary glaucoma 14 . A recent retrospective study reported that DM was not associated with fibrin formation, but the dog age was associated with fibrin formation 22 .…”

“…However, both topical corticosteroids and NSAIDs can cause IOP elevations according to previous reports 6,12,13 . Proposed mechanisms include alterations in the morphology or extracellular matrix constituents within the trabecular meshwork or aqueous humor outflow pathway, 13,14 leading to increased outflow resistance of aqueous humor 15–17 . In particular, topical or systemic NSAIDs, including flurbiprofen, diclofenac, and flunixin meglumine, have been reported to induce IOP elevations in veterinary ophthalmology 15,16,18 .…”

Retrospective evaluation of the incidence of gastrointestinal bleeding in dogs receiving ophthalmic nonsteroidal anti‐inflammatory drugs

“…Administration of topical ophthalmic nonsteroidal anti‐inflammatory drugs (NSAIDs) is essential in preventing and managing uveitis to reduce ocular discomfort in dogs 1,2 . When administered systemically, NSAIDs are an important risk factor for gastrointestinal (GI) bleeding, ulceration, and perforation in dogs 3–5 …”

“…Administration of topical ophthalmic nonsteroidal antiinflammatory drugs (NSAIDs) is essential in preventing and managing uveitis to reduce ocular discomfort in dogs. 1,2 When administered systemically, NSAIDs are an important risk factor for gastrointestinal (GI) bleeding, ulceration, and perforation in dogs. [3][4][5] Because the systemic absorption of topical NSAIDs is assumed to be low, these drugs are often given to dogs with other risk factors for GI bleeding, such as concurrent administration of systemic NSAIDs or glucocorticoids, and comorbidities that predispose to GI bleeding and ulceration.…”