Treatment of ocular hypotony

Methods for treating ocular hypotony are disclosed.

FIELD OF THE INVENTION 
This invention is directed to the use of mineralocorticoids to treat ocular 
hypotony. 
BACKGROUND OF THE INVENTION 
It has been suggested that mineralocorticoids may be associated with ocular 
dynamics by increasing the rate of aqueous humor formation. The endogenous 
mineralocorticoid, aldosterone, has been found in the aqueous humor, see 
Starka, et al., Aldosterone: Its Occurrence, Metabolism and Binding in the 
Rabbit Eye, Exp. Eye Res., Vol. 25, pp. 91-98 (1977); and 
mineralocorticoid receptors have been found in the ciliary process, see 
Starka, et al., cited above and Starka, et al., Aldosterone Binding in 
Bovine Ciliary Body, Endocrinologia Experimentalis, Vol. 11, pp. 203-208 
(1977). Panigrahy, et al. showed that endogenous aldosterone is involved 
in the regulation of intraocular pressure in the rabbit eye, see 
Modulation of Intraocutar Pressure by Aldosterone and Spironolactone, 
Investigative Ophthalmology & Visual Science, Vol. 35, No. 4, p. 1388 
(Mar. 15, 1994). The results of a study by Frenkel, et al. in Effects of 
Two Mineralocorticoids on Ocular Tension, Archives of Ophthalmology, Vol. 
72, pp. 315-318 (1964) suggests that systemic mineralocorticoids can 
increase aqueous influx in the eye and produce a rise in ocular tension in 
some glaucoma patients. 
SUMMARY OF THE INVENTION 
This invention is directed to a method for treating ocular hypotony by the 
topical application of mineralocorticoids. 
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
Ocular hypotony is a condition of reduced tension in the eye. It can be a 
serious complication in glaucoma treatment, for example, following 
glaucoma filtration surgery. In addition, in some glaucoma patients, the 
drugs used to control the patient's intraocular pressure can lower the 
pressure to the point that the eye globe partially collapses. 
There is currently no effective method for pharmacologically treating 
ocular hypotony. Generally, the condition remains untreated or intraocular 
injections of a viscous substance, such as, sodium hyaluronate are used. 
The topical use of mineralocorticoids to treat hypotony provides a 
preferred method for treating the condition. 
The mineralocorticoids are included in formulations that can be applied 
topically to the eye of warm-blooded animals, such as solutions, 
suspensions, gels, or ointments. They are present in the formulations at 
concentrations of from 0.05-5.0 weight percent (wt. %). The formulations 
can include other components known to those skilled in the art of 
formulating ophthalmic products. For example, the formulations can include 
ophthalmically acceptable preservatives, surfactants, viscosity enhancers, 
penetration enhancers, and buffers. The formulations are administered 
topically to the eye as needed to reach and maintain the appropriate 
intraocular pressure according to the routine discretion of the skilled 
clinician. 
Preferred mineralocorticoids include aldosterone, dihydrocortisol (which 
has mineralocorticoid activity, see Marver, et al., Dihydrocortisol: A 
Potential Mineratocorticoid, Journal of Steroid Biochemistry, Vol. 9, pp. 
1-7 (1978)), fludrocortisone, and 11-desoxycorticosterone. Most preferred 
is aldosterone. The structures for these compounds are set forth below. 
##STR1## 
The following examples are illustrative of the types of formulations which 
are useful in treating ocular hypotony, they are not meant to be limiting.