TREATMENT OF GLAUCOMA WITH 3-ALPHA,5-BETA-TETRAHYDROCORTISOL - A NEW THERAPEUTIC MODALITY

The effectiveness of 3 alpha, 5 beta-tetrahydrocortisol (3 alpha, 5 be ta-THF), a metabolite of cortisol, in lowering intraocular pressure (I OP) in rabbits made ocular hypertensive with glucocorticoids suggested its use in patients with Primary Open Angle Glaucoma (POAG). Patients with well-documented POAG were treated with a 1% suspension of 3 alph a, 5 beta-THF administered to one eye four times daily for up to six w eeks. Eight out of nine patients experienced an appreciable decrease i n IOP in the treated eye (average decrease 4.9 mm Hg). There was no co njunctival irritation, corneal pathology, visual field changes, altera tion in liver or renal function tests or blood count during the treatm ent period. The present study demonstrates that 3 alpha, 5 beta-THF, a naturally occurring steroid metabolite, is effective in lowering IOP in patients with POAG. Antiglucocorticoids may represent a new therape utic modality for the management of POAG.