Intravenous hypertonic saline to reduce intraocular pressure

Purpose: To quantitate the effect of intravenous hypertonic saline (IVHTS) injection on elevated intraocular pressure (IOP). Methods: Nineteen patients (median age, 65years; range, 41-84years) with glaucoma and an IOP 30mmHg or higher were recruited. A bolus of IVHTS (sodium chloride concentration 23.4%) was injected in an antecubital vein over 10-20seconds. The IOP and systolic and diastolic blood pressure (BP) were measured frequently for 2hr. The dosage was 0.5mmol/kg sodium in 11 patients (Group 1) and 1.0mmol/kg in eight patients (Group 2). Results: In both groups, a median absolute IOP reduction of 7mmHg was achieved in 5min. The maximum median reduction was 7mmHg (range, 4-16) and 9mmHg (range, 3-14) at 5 and 16min after IVHTS in Group 1 and 2, respectively, at which point the median IOP had reduced from 38 and 35mmHg to 31 and 27mmHg (p<0.001), respectively. In both groups, the IOP remained 7mmHg reduced 2hr after IVHTS. Systolic BP increased a median of 14.5mmHg at 3min and was comparable with baseline after 6min. Conclusion: Intravenous hypertonic saline solution reduces IOP moderately within minutes for up to 2hr.