Martínez Antonio, Sánchez Manuel
Instituto Gallego de Oftalmologia, La Coruña, Spain.
Curr Med Res Opin. 2007 Mar;23(3):595-9. doi: 10.1185/030079906X167688.
To evaluate the intraocular pressure lowering effect of the dorzolamide/timolol fixed combination (DTFC) in non-responder glaucoma patients to prostaglandin analogs/prostamides (prostas).
All glaucoma patients treated with DTFC, between June 2003 and December 2005, who were unresponsive to prostaglandin analogs/prostamides, were identified through a retrospective medical records review. A non-responder was defined as an intraocular pressure (IOP) lowering effect less than 15% compared with baseline measurement. Two 12-hour IOP diurnal curves, measured between 8:00 a.m. and 8:00 p.m. (8:00 a.m., 10:00 a.m., 12:00 noon, 2:00 p.m., 4:00 p.m., 6:00 p.m. and 8:00 p.m.), were obtained retrospectively from the records of 31 patients, the first while on prostaglandin analogs/prostamides (baseline IOP) and the second while receiving DTFC (DTFC IOP). The study outcomes were the change in mean diurnal IOP and the reduction in IOP fluctuation as a result of receiving DTFC in patients unresponsive to prostas. The IOP was evaluated by intragroup comparisons with a two-tailed paired Student's t-test. A chi-square test was adopted for analysis of categorical variables.
31 patients were included in this retrospective study. DTFC significantly reduced IOP in the patients overall, from 25.4 (3.5) to 20.2 (1.0) mmHg, p < 0.0001. The majority of patients were diagnosed with pseudoexfoliative glaucoma (PEX) (58%; 18/31). DTFC reduced the mean IOP fluctuations over 12 hours (highest minus lowest IOP reading within the 12-hours pressure curve) from 8.6 (3.2) to 4.3 (1.4) mmHg, p < 0.0001. The most common adverse events were ocular burning (16%) and taste perversion (13%). There were no serious treatment-related adverse events.
DTFC significantly reduced the IOP in patients with glaucoma who did not respond to prostaglandin analogs/prostamides. Further research is needed to confirm these results.
评估多佐胺/噻吗洛尔固定复方制剂（DTFC）对前列腺素类似物/前列腺酰胺类药物（前列腺素类）治疗无效的青光眼患者的降眼压效果。
通过回顾性病历审查，确定2003年6月至2005年12月期间所有接受DTFC治疗且对前列腺素类似物/前列腺酰胺类药物无反应的青光眼患者。无反应者定义为眼压（IOP）降低效果与基线测量值相比小于15%。回顾性地从31例患者的记录中获取两条12小时眼压日曲线，测量时间为上午8:00至晚上8:00（上午8:00、上午10:00、中午12:00、下午2:00、下午4:00、下午6:00和晚上8:00），第一条是在使用前列腺素类似物/前列腺酰胺类药物时（基线眼压），第二条是在接受DTFC时（DTFC眼压）。研究结果是对前列腺素类药物治疗无效的患者接受DTFC后平均日眼压的变化以及眼压波动的降低情况。通过组内比较采用双尾配对学生t检验评估眼压。采用卡方检验分析分类变量。
本回顾性研究纳入31例患者。DTFC使患者总体眼压显著降低，从25.4（3.5）mmHg降至20.2（1.0）mmHg，p < 0.0001。大多数患者被诊断为假性剥脱性青光眼（PEX）（58%；18/31）。DTFC使12小时内的平均眼压波动（12小时压力曲线内最高眼压读数减去最低眼压读数）从8.6（3.2）mmHg降至4.3（1.4）mmHg，p < 0.0001。最常见的不良事件是眼部烧灼感（16%）和味觉异常（13%）。未出现严重的治疗相关不良事件。
DTFC可使对前列腺素类似物/前列腺酰胺类药物治疗无效的青光眼患者眼压显著降低。需要进一步研究来证实这些结果。
