Nesher Ronit, Ticho Uriel
Glaucoma Service, Department of Ophthalmology, Sapir Medical Center, Kfar Saba, Israel.
Isr Med Assoc J. 2003 Apr;5(4):260-3.
The frequent systemic side effects associated with the use of systemic carbonic anhydrase inhibitors have adversely affected the compliance to treatment in glaucoma patients, obviating their long-term use. The introduction of the topical CAI dorzolamide has further reduced their use. However, the tolerability of dorzolamide in patients who have been intolerant to systemic CAIs has not been evaluated prospectively.
To study the tolerability and efficacy of dorzolamide (a topical CAI) in a selected group of glaucoma and ocular hypertensive patients who have been intolerant to systemic CAI.
A 3 month prospective study was conducted in 39 patients. Following recruitment, patients were evaluated on the day of switching from systemic CAI to dorzolamide and for five more visits. The SF-36 health assessment questionnaire was used to evaluate changes in well-being and quality of life, and the intraocular pressure was measured periodically.
Within 4 weeks of switching from systemic CAI to dorzolamide, the mean health assessment scores improved significantly in seven of the eight categories of the SF-36, and remained generally unchanged for the rest of the study. No significant differences were noted between the mean IOP on day 0 and the following measurements throughout the 84 days of dorzolamide therapy.
In glaucoma patients who were intolerant to systemic CAI, topical CAI dorzolamide offers a similar efficacy and better tolerability.
全身应用碳酸酐酶抑制剂常伴有全身性副作用，这对青光眼患者的治疗依从性产生了不利影响，从而限制了其长期使用。局部用碳酸酐酶抑制剂多佐胺的出现进一步减少了全身用碳酸酐酶抑制剂的使用。然而，多佐胺在对全身用碳酸酐酶抑制剂不耐受的患者中的耐受性尚未得到前瞻性评估。
研究多佐胺（一种局部用碳酸酐酶抑制剂）在一组对全身用碳酸酐酶抑制剂不耐受的青光眼和高眼压症患者中的耐受性和疗效。
对39例患者进行了为期3个月的前瞻性研究。招募患者后，在从全身用碳酸酐酶抑制剂转换为多佐胺当天以及之后的五次随访中对患者进行评估。使用SF - 36健康评估问卷评估幸福感和生活质量的变化，并定期测量眼压。
从全身用碳酸酐酶抑制剂转换为多佐胺后的4周内，SF - 36八个类别中的七个类别平均健康评估得分显著改善，在研究的其余时间内总体保持不变。在多佐胺治疗的84天中，第0天的平均眼压与后续测量值之间未发现显著差异。
在对全身用碳酸酐酶抑制剂不耐受的青光眼患者中，局部用碳酸酐酶抑制剂多佐胺具有相似的疗效和更好的耐受性。
