Dr. Amit Kumar Verma, Dr. Naweed Alam, Dr. P. K. Sahu, Dr Shiva Narang, Dr Khan Amir Maroof


Introduction: Tiotropium is a long acting anti-muscarinic agent (LAMA) recommended in management of chronic obstructive pulmonary disease
(COPD) as a bronchodilator. Being anti-muscarinic agent, it has many other effects on body like dryness of mouth, urinary retention, raised intra
ocular pressure (IOP) and rarely angina. In eye it causes pupillary dilation leading closure of anterior chamber angle, rise in intra ocular pressure
and precipitate glaucoma.
In this regard available data has conflicting reports. Some suggest rise in intra ocular pressure but others oppose it. So we planned this study to see
effect of tiotropium on intra ocular pressure.
Aim: To study the effect of inhaled antimuscarinic agent tiotropium on intraocular pressure in patients of chronic obstructive pulmonary disease (COPD).
Objective: To measure intra ocular pressure changes in COPD patients on tiotropium at baseline, at one month and after three months follow up.
Materials and methods: 65 patients were recruited from chest clinic and OPD from department of Medicine of UCMS and GTB Hospital. It was a
prospective observational cohort study conducted from November 2017 – April 2019. Ophthalmological assessment of patients was done by
using Goldmann applanation tonometer. This was done in department of ophthalmology by the same observer each time.
Results: There was a statistically significant difference observed in IOP over three months when compared by using paired t-test and p-value
was 0.002.
Conclusion: There was statistically significant change in mean IOP at the end of study compared to baseline by use of inhaled tiotropium
bromide in COPD patients.


Tiotropium, COPD, Intra ocular pressure

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