THE FOLLOWING study on the treatment of glaucoma with the carbonic anhydrase inhibitor acetazoleamide ( 2-acetylamino-1,3,4-thiadiazole-5-sulfonamide; Diamox) was initiated in October, 1953, and covers a four-month period of observation.
Inhibition of carbonic anhydrase by acetazoleamide is a new and useful means of lowering the intraocular pressure. Acetazoleamide, a heterocyclic sulfonamide, was developed by Roblin and associates, in 1950,* as a diuretic agent whose action was based on inhibition of carbonic anhydrase in the renal tubular epithelium. Carbonic anhydrase catalyzes the hydration of carbon dioxide to form carbonic acid: H2O+CO2⇄ H2CO3. The carbonic acid dissociates to form H+ and HCO3-. Thus, the level of hydrogen ions and bicarbonate ions is affected by this enzyme. In the kidney there ensues a hydrogen-sodium exchange between the tubular epithelium and the glomerular filtrate, resulting in the normal conservation of base and the formation of an acid urine.
BREININ GM, GÖRTZ H. CARBONIC ANHYDRASE INHIBITOR ACETAZOLEAMIDE (DIAMOX)A New Approach to the Therapy of Glaucoma. AMA Arch Ophthalmol. 1954;52(3):333-348. doi:10.1001/archopht.1954.00920050335001