Schröder Anke, Erb Carl
Augenklinik der Medizinischen Hochschule Hannover, Germany.
Klin Monbl Augenheilkd. 2002 Jul;219(7):533-6. doi: 10.1055/s-2002-33586.
Several animal models demonstrated that NMDA-receptor antagonists like memantine inhibit the excitotoxic action of glutamate in glaucoma. Furthermore, this also enables to slow down the degeneration of retinal ganglion cells. In the following case report we investigated the use and tolerability of memantine in a glaucoma patient.
We report on a 73-year old male with progressive glaucoma damage. Treatment with memantine à 20 mg/d lasted for 6 months and was preceded by one week à 10 mg/d. Follow-ups with perimetry and VEP were performed at beginning and 2, 4, 6 and 12 months after.
The first control showed an improvement of perimetry. The following examinations demonstrated a stabilization of perimetry and VEP. Because of side-effects there was no tolerability of a higher dose of memantine à 30 mg/d or continuation of the therapy after 6 months.
Memantine seems to be neuroprotective in glaucoma patients. At present a multicentric study is under way. More results may be expected shortly.
多种动物模型表明,像美金刚这样的N-甲基-D-天冬氨酸(NMDA)受体拮抗剂可抑制青光眼患者体内谷氨酸的兴奋性毒性作用。此外,这还能减缓视网膜神经节细胞的退化。在以下病例报告中,我们研究了美金刚在一名青光眼患者中的使用情况及耐受性。
我们报告了一名患有进行性青光眼损害的73岁男性。美金刚治疗剂量为每日20毫克,持续6个月,在此之前一周剂量为每日10毫克。在治疗开始时以及治疗后2、4、6和12个月进行了视野检查和视觉诱发电位(VEP)检查。
首次检查显示视野有所改善。后续检查表明视野和VEP保持稳定。由于出现副作用,无法耐受更高剂量(每日30毫克)的美金刚,且6个月后无法继续治疗。
美金刚似乎对青光眼患者具有神经保护作用。目前正在进行一项多中心研究。预计不久会有更多结果。