Brimonidine, a newly approved α2-adrenoceptor agonist, is a 2- imidazoline derivative which is more highly selective for the α2- adrenoceptor than either clonidine or apraclonidine. The mechanism of action by which it lowers intraocular pressure (IOP) involves a decrease in aqueous humor production and an increase in aqueous humor outflow through the uveoscleral pathway. Clinical studies have been performed for acute indications using the 0.5% concentration and chronic indications using the 0.2% concentration. This review discusses the mechanism of action, efficacy, and safety of this new compound.
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