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Bronchial Reactivity in Healthy Individuals Undergoing Long-term Topical Treatment With -Blockers

Stefano A. Gandolfi, MD; Alfredo Chetta, MD; Luca Cimino, MD; Paolo Mora, MD; Chiara Sangermani, MD; Maria Grazia Tardini, AO

Arch Ophthalmol. 2005;123:35-38.

Objective  To assess the impact of long-term treatment with topical timolol on bronchial reactivity in healthy individuals.

Methods  Twenty-one otherwise healthy individuals with high-pressure primary open-angle glaucoma were enrolled in a randomized controlled clinical trial. Eleven patients underwent 3 years of topical 0.5% timolol treatment followed by a 1-year washout period; 10 patients underwent primary argon laser trabeculoplasty. Functional variables and bronchial reactivity (forced expiratory volume in 1 second and metacholine challenge test results) were assessed in both groups at enrollment and after 3 and 4 years of follow-up.

Results  After 3 years, a measurable response to metacholine challenge was recorded in 6 of 11 otherwise symptom-free individuals treated with 0.5% timolol twice daily. A detectable response to metacholine challenge was still present in half of these individuals (3 of 6) when further washed out for 1 year from the topical -blocker. No significant variation in bronchial reactivity was measured in the laser-treated group during 4 years of follow-up.

Conclusions  Healthy individuals who undergo long-term topical application of a nonselective -blocker (0.5% timolol) can develop a subclinical increase in bronchial reactivity. This phenomenon may not be completely reversible on withdrawal of the -blocker.

Author Affiliations: Glaucoma Service, Institute of Ophthalmology (Drs Gandolfi, Cimino, Mora, and Sangermani and Ms Tardini), and Department of Respiratory Disease (Dr Chetta), University of Parma, Parma, Italy.

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