Koz Ozlem Gurbuz, Ozsoy Arzu, Yarangumeli Alper, Kose S Kenan, Kural Gulcan
First Eye Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Acta Ophthalmol Scand. 2007 Dec;85(8):838-43. doi: 10.1111/j.1600-0420.2007.00960.x. Epub 2007 Aug 2.
To study the effect of three prostaglandin F(2)-alpha (PG) analogues on retrobulbar blood flow velocity in previously untreated patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT), using colour Doppler ultrasound.
Sixty newly diagnosed patients with POAG or OHT were randomly assigned to travoprost 0.004% (n = 12 with POAG, n = 8 with OHT), latanoprost 0.005% (n = 11 with POAG, n = 9 with OHT) and bimatoprost 0.03% (n = 13 with POAG, n = 7 with OHT) treatment groups in a double-masked fashion. At baseline examination, blood pressure, heart rate and intraocular pressure (IOP) were recorded. Peak-systolic and end-diastolic velocities were measured in the ophthalmic (OA), central retinal (CRA) and temporal short posterior ciliary arteries (PCA). The resistive index (RI) and ocular perfusion pressure (OPP) were determined for each treatment group. After a treatment period of 6-months, all procedures were repeated.
There were no significant differences in age (53 +/- 14 years in the travoprost group, 51 +/- 14 years in the latanoprost group, 53 +/- 11 years in the bimatoprost group), gender (11 men, nine women; 11 men, nine women; 13 men, seven women, by group, respectively), or clinical diagnosis (POAG or OHT) among treatment groups (p > 0.05). A significant decrease in IOP (baseline: 26.4 +/- 3.3 mmHg, 26.8 +/- 1.3 mmHg, 25.8 +/- 1.8 mmHg, respectively; month 6: 20.9 +/- 1.9 mmHg, 20.8 +/- 2.4 mmHg, 18.3 +/- 1.2 mmHg, respectively; p < 0.0001) and an increase in OPP (baseline: 33.7 +/- 3.8 mmHg, 33.5 +/- 3.2 mmHg, 33.9 +/- 2.6 mmHg, respectively; month 6: 40.2 +/- 3.5 mmHg, 39.9 +/- 3.1 mmHg, 41.7 +/- 2.6 mmHg, respectively; p < 0.0001) were verified in all three groups during the study period. Mean baseline RI values for the CRA in the travoprost group and the OA in the latanoprost group were both 0.7 +/- 0.1 mmHg and both values were statistically significantly lower at 6 months (0.6 +/- 0.1 mmHg in both groups; p = 0.002, p < 0.0001, respectively). In the bimatoprost group there was no statistically significant difference in haemodynamic parameters over the study period (p > 0.05).
Our results suggest that the three PG analogues significantly reduce IOP and increase OPP in patients with POAG or OHT. Topical travoprost and latanoprost significantly reduce the RI of the CRA and OA, respectively. We were unable to determine any effect of topical bimatoprost on ocular haemodynamics.
使用彩色多普勒超声研究三种前列腺素F(2)-α（PG）类似物对未经治疗的原发性开角型青光眼（POAG）或高眼压症（OHT）患者球后血流速度的影响。
60例新诊断的POAG或OHT患者被随机双盲分配到0.004%曲伏前列素治疗组（12例POAG患者，8例OHT患者）、0.005%拉坦前列素治疗组（11例POAG患者，9例OHT患者）和0.03%比马前列素治疗组（13例POAG患者，7例OHT患者）。在基线检查时，记录血压、心率和眼压（IOP）。测量眼动脉（OA）、视网膜中央动脉（CRA）和颞侧睫状后短动脉（PCA）的收缩期峰值和舒张末期速度。确定每个治疗组的阻力指数（RI）和眼灌注压（OPP）。经过6个月的治疗期后，重复所有检查步骤。
治疗组之间在年龄（曲伏前列素组53±14岁，拉坦前列素组51±14岁，比马前列素组53±11岁）、性别（分别为11男9女、11男9女、13男7女）或临床诊断（POAG或OHT）方面无显著差异（p>0.05）。在研究期间，所有三组患者的眼压均显著降低（基线时分别为26.4±3.3 mmHg、26.8±1.3 mmHg、25.8±1.8 mmHg；第6个月时分别为20.9±1.9 mmHg、20.8±2.4 mmHg、18.3±1.2 mmHg；p<0.0001），眼灌注压均升高（基线时分别为33.7±3.8 mmHg、33.5±3.2 mmHg、33.9±2.6 mmHg；第6个月时分别为40.2±3.5 mmHg、39.9±3.1 mmHg、41.7±2.6 mmHg；p<0.0001）。曲伏前列素组CRA和拉坦前列素组OA的平均基线RI值均为0.7±0.1 mmHg，且在6个月时这两个值均显著降低（两组均为0.6±0.1 mmHg；分别为p=0.002，p<0.0001）。在比马前列素组，研究期间血流动力学参数无统计学显著差异（p>0.05）。
我们的结果表明，三种PG类似物可显著降低POAG或OHT患者的眼压并升高眼灌注压。局部应用曲伏前列素和拉坦前列素分别显著降低CRA和OA的RI。我们无法确定局部应用比马前列素对眼部血流动力学的任何影响。
