Orzalesi Nicola, Rossetti Luca, Bottoli Andrea, Fogagnolo Paolo
Eye Clinic, Department of Medicine, Surgery and Odontoiatry, University of Milan San Paolo Hospital, Milan, Italy.
Ophthalmology. 2006 Feb;113(2):239-46. doi: 10.1016/j.ophtha.2005.10.045.
To compare 24-hour reduction in intraocular pressure (IOP) by latanoprost 0.005%, travoprost 0.004%, and bimatoprost 0.03% in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OH).
Randomized, double-masked, crossover study.
Twenty-four patients with POAG and 20 with OH.
Patients were treated with latanoprost, travoprost, and bimatoprost for 1 month. The treatment sequence was randomized, and washout lasted 30 days for each trial drug. Four 24-hour tonometric curves were recorded for each patient: 1 at baseline and 1 after each treatment period.
Intraocular pressure was measured at 3, 6, and 9 am; noon; 3, 6, and 9 pm; and midnight by 2 treatment-masked well-trained evaluators using a handheld electronic tonometer with the patient in supine and sitting positions and a Goldmann applanation tonometer with the patient sitting at the slit lamp. Supine systemic blood pressure was recorded at the same times. A randomized-blocks analysis of variance was used to analyze data.
All 3 drugs were highly effective in reducing IOP when compared to baseline. Mean IOP reductions were similar after the 3 prostaglandin analogs, and none of the differences among treatments reached statistical significance. The drugs' effect was significantly greater during the daytime (9 am-9 pm) than during the nighttime (midnight-6 am) with all prostaglandin analogs. In 7 of 44 patients (16%), nocturnal IOP was significantly higher than diurnal IOP, both at baseline and under the 3 prostaglandin analogs.
From a clinical point of view, the overall results seem to indicate that the 3 prostaglandin analogs are powerful agents in controlling round-the-clock IOP in POAG and OH patients.
比较0.005%拉坦前列素、0.004%曲伏前列素和0.03%比马前列素对原发性开角型青光眼（POAG）或高眼压症（OH）患者24小时眼压（IOP）的降低情况。
随机、双盲、交叉研究。
24例POAG患者和20例OH患者。
患者接受拉坦前列素、曲伏前列素和比马前列素治疗1个月。治疗顺序随机，每种试验药物的洗脱期为30天。为每位患者记录4条24小时眼压曲线：1条在基线时，1条在每个治疗期后。
由2名经过良好训练且对治疗情况不知情的评估人员，使用手持式电子眼压计，在患者仰卧位和坐位时，于上午3点、6点和9点；中午；下午3点、6点和9点；以及午夜测量眼压；并使用戈德曼压平眼压计，在患者坐在裂隙灯前时测量眼压。同时记录仰卧位的全身血压。采用随机区组方差分析来分析数据。
与基线相比，所有3种药物在降低眼压方面都非常有效。3种前列腺素类似物治疗后平均眼压降低情况相似，治疗之间的差异均未达到统计学显著性。所有前列腺素类似物在白天（上午9点至下午9点）的药物效果显著大于夜间（午夜至上午6点）。在44例患者中的7例（16%）中，无论是在基线时还是在3种前列腺素类似物治疗下，夜间眼压均显著高于日间眼压。
从临床角度来看，总体结果似乎表明这3种前列腺素类似物是控制POAG和OH患者全天眼压的有效药物。
