apraclonidine / Generic mfg. - LARVOL DELTA

Systemic Toxicity With Use of Apraclonidine Ophthalmic Drops in Pediatric Patients. (PubMed, JAMA Ophthalmol) - "This case series suggests use of apraclonidine in pediatric patients poses a risk of central α-2 adrenergic agonist-induced central nervous system and respiratory depression. Clinicians who use apraclonidine in the pediatric population should be aware of potential serious systemic effects from ophthalmic use of the drug and be prepared to manage these."

Journal • Cardiovascular • CNS Disorders • Depression • Ophthalmology • Pediatrics • Psychiatry • Respiratory Diseases

Iatrogenic Blepharoptosis: Multimodal Management and Treatment Technique With Botulinum Toxin Type A. (PubMed, Dermatol Res Pract) - "Once it has happened, it is important to recognize the severity of the blepharoptosis (which is classified as mild, moderate, or severe), in order to decide whether to use oxymetazoline or apraclonidine eye drops, muscle exercises, vibrating devices, radiofrequency, and the latest option described with pretarsal BoNT-A application...Blepharoptosis following esthetic BoNT-A treatment is a rare complication among trained injectors. Knowledge of therapeutic options, including pretarsal BoNT-A injection techniques, is crucial for managing this complication, which can have significant esthetic and functional impacts."

Journal • Review • Aesthetic Medicine

Horner syndrome following endoscopic thyroid surgery (ETS): a report of two cases and literature review. (PubMed, Front Med (Lausanne)) - "Pharmacologic tests utilizing drugs such as Apraclonidine, Cocaine, and Hydroxyamphetamine aid in the diagnosis of HS, while short-term use of steroids and neurotrophins may expedite recovery...Preoperative patient counseling about HS risk is crucial. This study underscores HS as non-life-threatening yet distressing complication, advocating for refined surgical techniques and heightened anatomical awareness to avoid CSC injury during ETS."

Journal • Oncology • Ophthalmology • Solid Tumor • Thyroid Gland Carcinoma • Thyroid Gland Papillary Carcinoma • ERG

Oxymetazoline and Blepharoptosis: A Case Series and Proposed Treatment Algorithm. (PubMed, Cureus) - "Pharmacologic treatments such as apraclonidine and phenylephrine eyedrops have been used but are limited by significant adverse effects, including pupil dilation and ocular/systemic side effects...Its extended duration of effectiveness and favorable safety profile make it an attractive choice for patients. The proposed treatment algorithm simplifies decision-making for clinicians and enhances patient satisfaction and quality of life."

Journal • Aesthetic Medicine • Ophthalmology

A Comparative Assessment of Intraocular Pressure Changes After Aflibercept 8 mg and Faricimab-svoa Intravitreal Injections in Wet Age-Related Macular Degeneration. (PubMed, Cureus) - "Formulations with higher concentrations, such as aflibercept 8 mg (Eylea HD; Bayer AG, Leverkusen, Germany), which are administered in larger volumes, may raise concerns about potential increases in intraocular pressure (IOP) and other ocular complications...The research recorded lens condition, the need for paracentesis, and the application of Iopidine drops...Conclusions Intravitreal injections of aflibercept 8 mg and faricimab-svoa caused a small and temporary increase in IOP and there were no cases requiring urgent management. Our results confirm the short-term ocular safety of aflibercept 8 mg and faricimab-svoa for the treatment of WetAMD and highlight the need for individualized monitoring for patients at risk of increased IOP."

Journal • Age-related Macular Degeneration • Macular Degeneration • Ophthalmology • Retinal Disorders • Wet Age-related Macular Degeneration

Validation of Monocular Pupillometry in Healthy Controls and Patients With Autonomic Dysfunction: Pupillary Biomarkers for Autonomic Failure. (PubMed, Eur J Neurol) - "The presented device provides accurate, reproducible assessments of pupillary autonomic function in healthy controls and patients with autonomic disorders. With normative data provided, it is an easily accessible, well-tolerated tool to quantitatively assess pupillomotor innervation in a broad clinical setting. Further studies are warranted to explore its potential as a noninvasive biomarker, complementing standard autonomic function tests for early detection, monitoring disease progression, and evaluating treatment response in disorders with autonomic failure."

Biomarker • Journal • CNS Disorders • Immunology

Differentiation of Horner Syndrome and Physiological Anisocoria by Automated Pupillometry. (PubMed, J Neuroophthalmol) - "Our results indicate that pupillometry is a robust tool to measure the dilation lag in Horner syndrome and, therefore, to distinguish pathological from physiological anisocoria obviating pharmacological testing. The high sensitivity of the test will allow to identify the patients with Horner syndrome requiring further investigation."

Journal • Ophthalmology

Horner syndrome after parathyroidectomy: case report (SOE 2025) - "The diagnosis of Horner Syndrome was confirmed by pharmacological testing with apraclonidine... This case underscores the importance of recognizing Horner Syndrome as a rare but noteworthy complication of thyroid and parathyroid surgeries. General surgeons should be aware of the vulnerability of the oculosympathetic pathway due to its close anatomical relationship with these structures. Ophthalmologists must be proficient in identifying Horner Syndrome as a potential consequence of cervical interventions, highlighting the importance of obtaining a detailed clinical history for accurate diagnosis and treatment."

Case report • Clinical • Ophthalmology

Collaboration Between Emergency Medicine and Optometry Aids in Diagnosing Atypical Wallenberg Syndrome in a 37-Year-Old Female. (PubMed, J Binocul Vis Ocul Motil) - "This case report highlights an atypical clinical presentation featuring ipsilateral head, neck, shoulder, and eye pain with erythema, edema of the right eyelid and conjunctiva, alongside classic signs of dorsolateral medullary syndrome, also known as Wallenberg Syndrome, characterized by ipsilateral Horner's syndrome and contralateral loss of body pain and temperature in a 37-year-old female. The correct diagnosis of Wallenberg syndrome was achieved through the collaborative effort of eye care professionals, primary care, emergency, and neurology specialties in medicine."

Journal • Atherosclerosis • Cardiovascular • Dermatology • Infectious Disease • Pain

Pharmacologic Agents Used in the Assessment or Correction of Blepharoptosis: A Report by the American Academy of Ophthalmology. (PubMed, Ophthalmology) - "Phenylephrine, cocaine, hydroxyamphetamine, apraclonidine, naphazoline, and oxymetazoline can achieve short-term blepharoptosis correction. Phenylephrine, cocaine, and hydroxyamphetamine have been described only in the context of in-office evaluation of blepharoptosis or Horner syndrome, and their therapeutic role remains uncertain. Oxymetazoline hydrochloride ophthalmic solution 0.1% is the only medication approved by the United States Food and Drug Administration for treatment of acquired blepharoptosis in adults. Independent validation studies may be warranted for oxymetazoline hydrochloride and its long-term efficacy and safety data remain uncertain."

Journal • Dry Eye Disease • Keratitis • Ocular Inflammation • Ophthalmology • Pain • Xerostomia

DEW422-C001: A Double-Masked Comparison of FID 123320 Ophthalmic Solution to Vehicle for the Reduction of Ocular Redness (clinicaltrials.gov) - P3 | N=159 | Completed | Sponsor: Alcon Research | Active, not recruiting ➔ Completed

Trial completion • Ophthalmology

DEW422-C001: A Double-Masked Comparison of FID 123320 Ophthalmic Solution to Vehicle for the Reduction of Ocular Redness (clinicaltrials.gov) - P3 | N=159 | Active, not recruiting | Sponsor: Alcon Research | Recruiting ➔ Active, not recruiting | N=240 ➔ 159

Enrollment change • Enrollment closed • Ophthalmology

Differentiation of Horner Syndrome and Physiological Anisocoria by Automated Pupillometry. (PubMed, J Neuroophthalmol) - "Our results indicate that pupillometry is a robust tool to measure the dilation lag in Horner syndrome and, therefore, to distinguish pathological from physiological anisocoria obviating pharmacological testing. The high sensitivity of the test will allow to identify the patients with Horner syndrome requiring further investigation."

Journal • Ophthalmology

Investigation of the molecular interaction between apraclonidine, an α2-adrenergic receptor agonist, and bovine serum albumin using fluorescence and molecular docking techniques. (PubMed, Spectrochim Acta A Mol Biomol Spectrosc) - "Analysis of synchronous and 3-D fluorescence signals revealed microenvironmental variations close to BSA's Trp and Tyr residues upon APR addition. Both the competitive site marker as well as molecular docking results detected that APR exhibited a stronger binding affinity towards Drug Site 2 (DS2) compared to Drug Site 1 (DS1)."

Journal • Cardiovascular

DEW422-C001: A Double-Masked Comparison of FID 123320 Ophthalmic Solution to Vehicle for the Reduction of Ocular Redness (clinicaltrials.gov) - P3 | N=240 | Recruiting | Sponsor: Alcon Research | Not yet recruiting ➔ Recruiting

Enrollment open • Ophthalmology

Efficacy of Topical Apraclonidine for the Treatment of Ocular Synkinesis (clinicaltrials.gov) - P4 | N=0 | Withdrawn | Sponsor: University of Alabama at Birmingham | N=10 ➔ 0 | Not yet recruiting ➔ Withdrawn

Enrollment change • Trial withdrawal • CNS Disorders

A Double-Masked Comparison of FID 123320 Ophthalmic Solution to Vehicle for the Reduction of Ocular Redness (clinicaltrials.gov) - P3 | N=240 | Not yet recruiting | Sponsor: Alcon Research

New P3 trial • Ophthalmology

Efficacy of Topical Apraclonidine for the Treatment of Ocular Synkinesis (clinicaltrials.gov) - P4 | N=10 | Not yet recruiting | Sponsor: University of Alabama at Birmingham | Trial completion date: Nov 2025 ➔ Nov 2028 | Trial primary completion date: Nov 2024 ➔ Nov 2027

Trial completion date • Trial primary completion date • CNS Disorders

Are Alpha-2 Adrenergic Agonists Being Used in Infants? (AAO 2023) - "Purpose To evaluate the frequency of reported adverse events for brimonidine or apraclonidine in infants aged 24 months or less despite a well-known black box warning. Conclusion Despite well-known black box labels, alpha-2 agonists have still been used in infants, with systemic, life-threatening complications ensuing. Additional safeguards may be needed."

Glaucoma • Ophthalmology

16 Horner Syndrome: Can it be Familial? Case series in a family and review of literature. (PubMed, BMJ Open Ophthalmol) - "The anisocoria was more noticeable in the dark, Horner syndrome was confirmed with apraclonidine test.Case 2: Mother of case 1, 50-year-old female diagnosed with right Horner syndrome at the age of 14 in Austria...Our cases demonstrate that familial presentation could indicate an idiopathic aetiology as it is unlikely to have pathological Horner syndrome in two first degree relatives.Our case series highlights the importance of eliciting a family history of Horner syndrome and examining the family members. Positive family history can reassure patients while awaiting results of investigations."

Journal • Review • Mood Disorders • Ophthalmology • Pediatrics

A CASE OF HORNER SYNDROME AFTER PRONING IN A CRITICALLY ILL PATIENT WITH ACUTE RESPIRATORY DISTRESS SYNDROME (CHEST 2023) - "Patient was also noted to have new anisocoria with extreme pinpoint pupil of the right eye with no response to apraclonidine... Thoracic outlet syndrome must be considered as a possible cause of acute Horner syndrome in critically ill patients who undergo prone positioning for ARDS. Knowledge of this can help improve proning protocols to ensure patients are in the proper position."

Clinical • Acute Respiratory Distress Syndrome • Critical care • Infectious Disease • Influenza • Ophthalmology • Pneumonia • Pulmonary Disease • Respiratory Diseases • Septic Shock • Vascular Neurology

Hydroinsertion With A Twist (ESCRS 2023) - " The full glaucoma protocol consists of using a clear temporal corneal incision (to reduce disturbance to any pre-existing glaucoma filtration bleb, and to preserve superior conjunctiva in case drainage surgery is required at a later date); topical and intracameral anaesthesia and avoidance of high volume sub-Tenons or peribulbar local anaesthesia which can cause huge intraorbital and thus intraocular pressure rise; deploying dispersive instead of cohesive ophthalmic viscoelastic device (OVD) where possible; full removal of OVD including behind the IOL; topical anti-hypertensives such as Iopidine or Timolol providing no contraindication; and oral Acetazolamide for up to two days. In addition to a full glaucoma protocol to protect vulnerable glaucomatous eyes against pressure spikes and rises, the IOL hydro-insertion adds to safety as no OVD is left within the anterior chamber at the end of cataract surgery. Hydro-insertion has been used by the senior author and his team..."

Cataract • Glaucoma • Ophthalmology

Segmental Zoster Paresis Accompanied by Horner's Syndrome. (PubMed, Intern Med) - "The right pupil was dilated with instillation of 1% apraclonidine, indicating Horner's syndrome. The patient was treated with intravenous acyclovir and methylprednisolone. Focal weakness related to zoster, generally known as segmental zoster paresis, improved over five months, but Horner's syndrome remained. We suggest that aggressive intravenous treatment should be considered for rare cases of zoster that occur with a combination of these two neurological conditions."

Journal • Herpes Zoster • Infectious Disease • Varicella Zoster

Efficacy of Topical Apraclonidine for the Treatment of Ocular Synkinesis (clinicaltrials.gov) - P4 | N=10 | Not yet recruiting | Sponsor: University of Alabama at Birmingham | Trial completion date: Nov 2024 ➔ Nov 2025 | Trial primary completion date: Nov 2023 ➔ Nov 2024

Trial completion date • Trial primary completion date • CNS Disorders

Efficacy of apraclonidine eye drops in treating ptosis secondary to myasthenia gravis: A pilot clinical trial. (PubMed, Muscle Nerve) - P2 | "Apraclonidine may alleviate ptosis secondary to MG and may be an effective alternative treatment for this group of patients."

Journal • CNS Disorders • Myasthenia Gravis