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To the Editor.—We read with great interest two adjacent articles in the December 1976 issue of the Archives by Becker and Shin (94:2057-2058) and by Shin and co-workers (94:2059-2060). These articles suggest that epinephrine hydrochloride responsiveness correlates with the occurrence of field loss in people with elevated intraocular pressure levels. This observation is important in trying to understand the pathogenic mechanism and the clinical manifestations in glaucoma.
However, we would like to urge caution in using "epinephrine responsiveness" as an indication for therapy in individuals with abnormal pressure, at least until further evidence is available. In a report by Becker and Morton (Am J Ophthalmol 62:272-277, 1966), 50 subjects were treated with epinephrine to one eye and followedup prospectively for four to five years. Of the seven individuals in whom visual field loss developed, only two were "epinephrine responders" by the criterion used in the recent article by Becker
Drance SM, Anderson DR. Epinephrine Hydrochloride Responsiveness. Arch Ophthalmol. 1977;95(5):894-895. doi:10.1001/archopht.1977.04450050172023