Chen Chang-Lin, Tseng Hang-Yi, Wu Kwou-Yeung
Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2006 Jun;22(6):266-70. doi: 10.1016/S1607-551X(09)70310-9.
The purpose of this study was to evaluate both the intraocular pressure (IOP)-decreasing and neuroprotective effects of Rescula (0.12% unoprostone isopropyl) as an alternative therapy to betablockers with a long-term drift effect in patients with glaucoma. Twenty-eight patients with unilateral or bilateral glaucoma were treated with Rescula instead of the original beta-blocker therapy. IOP was measured using a Goldmann applanation tonometer, and visual field defects were evaluated quantitatively by Humphrey automatic perimetry central 30-2 threshold test. The mean follow-up time was at least 1 year. Rescula achieved a significant (p = 0.00001) and long-lasting reduction in IOP (from 20.78 +/- 2.71 to 17.14 +/- 2.70 mmHg) in patients with open-angle glaucoma after 12 months of follow-up. It also demonstrated a significant (p = 0.02) IOP-reducing effect (from 20.67 +/- 3.60 to 16.36 +/- 3.67 mmHg) in patients with angle-closure glaucoma 12 months later. The mean deviation of visual field defects changed from -13.27 dB baseline to -10.64 dB at 12 months as evaluated by Humphrey field analyzer II central 30-2 threshold test after Rescula; however, there was no statistical difference (p = 0.098). Our results showed that Rescula has a significant IOP-reducing effect as an alternative therapy to beta-blockers with long-term drift effect in patients with open-angle and angle-closure glaucoma. However, a neuroprotective effect to prevent further progression of the visual field defect in patients with glaucoma was not demonstrated in this study.
本研究的目的是评估适利达（0.12%异丙前列素）对青光眼患者的降眼压作用及神经保护作用，以作为具有长期漂移效应的β受体阻滞剂的替代疗法。28例单侧或双侧青光眼患者接受了适利达治疗，替代了原有的β受体阻滞剂治疗。使用Goldmann压平眼压计测量眼压，并通过Humphrey自动视野计中央30-2阈值测试对视野缺损进行定量评估。平均随访时间至少为1年。随访12个月后，适利达使开角型青光眼患者的眼压显著（p = 0.00001）且持久降低（从20.78±2.71 mmHg降至17.14±2.70 mmHg）。12个月后，它在闭角型青光眼患者中也显示出显著（p = 0.02）的降眼压作用（从20.67±3.60 mmHg降至16.36±3.67 mmHg）。根据适利达治疗后通过Humphrey视野分析仪II中央30-2阈值测试评估，视野缺损的平均偏差从基线时的-13.27 dB变为12个月时的-10.64 dB；然而，没有统计学差异（p = 0.098）。我们的结果表明，作为具有长期漂移效应的β受体阻滞剂对开角型和闭角型青光眼患者的替代疗法，适利达具有显著的降眼压作用。然而，本研究未证明其对青光眼患者预防视野缺损进一步进展有神经保护作用。
