1120-6721/332-03$01.50/0 P. PIVETTI-PEZZI, S. DA DALT, M. LA CAVA, M. PINCA, F. DE GREGORIO, M. VIRNO European Journal of Ophthalmology / Vol. 10 no. 4, 2000 / pp. 332-334 Ibopamine treatment in chronic hypotony secondary to long-lasting uveitis. A case report INTRODUCTION Ocular hypotony is a potential complication of long- lasting intraocular inflammation that can progress to corneal failure, macular edema, optic nerve swelling and bulbar phthisis (1, 2). Medical treatment of irre- versible ocular hypotony resulting from chronic per- sistent uveitis is based mainly on local, peribulbar and systemically administered steroids whose efficacy, how- ever, is limited (3, 4). Ibopamine, an ester of methyl- dopamine, has been studied: by stimulating the pro- duction of aqueous humor, ibopamine raises intraocular pressure (IOP). This effect has been described in cas- es of ocular hypotony following post-operative pro- cedures (5-8). We describe a case of ocular severe hypotony sec- ondary to progressive chronic uveitis, treated suc- cessfully with ibopamine eye drops. Case report In February 1998 we examined for the first time a 47-year-old man with a 37-year history of bilateral diffuse uveitis, bilateral cataract extraction in 1970 and enucleation of LE in 1997, with persistent hypotony in RE since 1997 refractory to prolonged systemic and topical steroids. At the first examination he showed a best-corrected visual acuity (BCVA) of 4/50, diffuse corneal edema, 2+ flare and 1+ cells in the anterior chamber, seclusio pupillaris, epipupillary cyclitic membrane, aphakia, 2+ vitreous cells and opacities, optic disk swelling, diffuse chorioretinal atrophy and ischemic changes at the posterior pole. IOP was 2 mmHg, ultrasonography showed diffuse choroidal and optic disk edema and Goldmann perimetry gave a re- stricted visual field at 5°. A complete work-up for uveitis was unremarkable, as was his medical history, except PURPOSE. To assess the clinical efficacy of ibopamine eye drops in severe hypotony sec- ondary to chronic progressive uveitis. METHODS. Case report. A 47-year-old man with a 37-year history of diffuse uveitis and se- vere refractory hypotony was treated with topical 2% ibopamine (Trazyl ® ) six times a day. Intraocular pressure, visual acuity, visual field and side effects were recorded during 15 months of follow-up. RESULTS. IOP, visual acuity and visual field increased after four days of therapy and lasted for two months when the drug was suspended because of the onset of filamentous ker- atopathy. A new course of treatment with 2% ibopamine eye drops in a different solvent (BSS ® ) resulted in a stable increase in IOP, VA and visual field, with no side effects in a fol- low-up of 13 months. CONCLUSIONS. Ibopamine 2% eye drops in BSS ® solvent seem effective in the treatment of uveitis-related hypotony. (Eur J Ophthalmol 2000; 10: 332-4) KEY WORDS. Hypotony, Ocular pressure, Uveitis Accepted: June 26, 2000 © by Wichtig Editore, 2000 Institute of Ophthalmology, University of Roma “La Sapienza”, Roma - Italy Case report SHORT COMMUNICATION