Adverse Events and Intraocular Pressure-Lowering Effect of Topical 0.5% Apraclonidine in Childhood Glaucoma: A Retrospective Single-Center Study

Ophthalmol Glaucoma. 2026 Mar 10:S2589-4196(26)00032-3. doi: 10.1016/j.ogla.2026.03.002. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the adverse events and intraocular pressure (IOP)-lowering effects of topical apraclonidine in childhood glaucoma management.

DESIGN: A retrospective case series.

PARTICIPANTS: Glaucoma patients aged <18 years who had received topical apraclonidine METHODS: We extracted data on demographics, ocular and systemic adverse events, and IOP reduction. We defined and classified childhood glaucoma based on the Childhood Glaucoma Research Network criteria.

MAIN OUTCOMES MEASURES: Adverse events and IOP-lowering effect of topical 0.5% apraclonidine.

RESULTS: We included 108 eyes (90 patients). Glaucoma associated with non-acquired systemic disease or syndrome (36 eyes, 33.3%) was the most common diagnosis, followed by glaucoma following cataract surgery (29 eyes, 26.9%). The median age at glaucoma diagnosis was 32 months (Interquartile Range [IQR]: 5.3-68.5 months). The median age at the start of apraclonidine was 5 years (IQR = 3-9). The mean number of glaucoma medications on apraclonidine initiation was 2.7±0.8. The median duration for apraclonidine use was 327 days (IQR = 42-665). There were no local adverse events reported, and only two cases of systemic adverse events (one case (1.1%) of night terror and one case (1.1%) of somnolence). The mean IOPs were 30±4.6 mmHg (n = 85 eyes) and 24.9±4 mmHg (n = 20 eyes) at baseline and 6 months after use, respectively.

CONCLUSION: Topical apraclonidine use demonstrated a low rate of reported adverse events and was associated with clinically meaningful IOP reduction as an adjunctive treatment in childhood glaucoma.

PMID:41819490 | DOI:10.1016/j.ogla.2026.03.002