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Question Asked By
anonymous
2005-09-25
Glaucoma and Minoxidil
Question
A patient recently wrote that he recently read an article that says there is a link between increased pressure in the eye (glaucoma) and the use of Rogaine/minoxidil. Is there, in fact, any relationship between minoxidil and glaucoma?
Answer
Not really. The occurrence of glaucoma is a known, albeit rare, contraindication for systemic use of the drug class known as nitrates (e.g. nitroglycerin), a long-used class of potent vasodilators. Whereas minoxidil is a potent vasodilator, it is not one of the nitrate drugs.
Whenever glaucoma is listed as a contraindication to the use of any drug, one must ask oneself to which form of glaucoma the warning is applicable. The answer, 100% of the time, is angle closure or narrow angle glaucoma. Unfortunately, unless the condition is diagnosed by an ophthalmologist, it is usually impossible to know that someone has a propensity toward this disorder, because diagnosis requires a special technique known as gonioscopy. When angle closure glaucoma is diagnosed, the only appropriate form of treatment is laser iridotomy, which is completely curative in well over 95% of cases.
If, on the other hand you have the run-of-the-mill open angle glaucoma, minoxidil can actually be beneficial in decreasing the intraocular pressure, whether applied topically or systemically. In studies of glaucoma filtering surgery done on rabbit eyes, topical minoxidil applied to the subconjunctival surface during surgery prevented fibroblast proliferation, and thus bleb scarring. In human studies, minoxidil inhibits keratocyte proliferation by a nontoxic mechanism. As such, minoxidil might be particularly useful for modulating corneal wound healing following excimer laser photorefractive keratectomy (LASIX surgery)*.
Bottom Line: Minoxidil has a clean record in regards to any association with glaucoma and could potentially be beneficial in this condition.
*The Effect of Minoxidil on Keratocyte Proliferation in Cell Culture, Stephen D. McLeod, Nishat P. Alvi, Lili Zhou, Yagnesh Dave, John W. Chandler, Richard Fiscella, Ophthalmic Research 1998;30:263-270.
Richard Lee, M.D.
T. Adam Bowen, D.O.
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