Kashiwagi Kenji, Tsumura Toyoaki, Tsukahara Shigeo
Department of Ophthalmology, University of Yamanashi Faculty of Medicine, Chuo, Yamanashi, Japan.
J Glaucoma. 2008 Dec;17(8):662-6. doi: 10.1097/IJG.0b013e318166656d.
To assess the long-term effects of latanoprost monotherapy on intraocular pressure (IOP) reduction in Japanese patients with glaucoma.
Those enrolled were patients with glaucoma who had been treated on an outpatient basis for more than 5 years at the Glaucoma Outpatient Clinic of the University of Yamanashi Hospital, with only latanoprost ophthalmic solution as the first drug of choice. Subjects who underwent treatment with a drug other than latanoprost, laser therapy, or surgery were eliminated from the study, and IOP reduction by latanoprost, the dropout rate and causative reasons, and the types of additional therapy were assessed in a retrospective manner.
Seventy-two patients (age: 68.3+/-13.0 y) were enrolled, including 40 men and 32 women for the checking of 72 eyes. There were 47 eyes with normal tension glaucoma (NTG) and 25 with primary open angle glaucoma (POAG). The mean duration of latanoprost monotherapy was 4.1+/-2.0 years (range: 5 mo to 7 y, median: 4.0 y). IOP reduction rates (cumulative dropout rates) relative to the mean IOP before the start of latanoprost monotherapy (17.8+/-3.4 mm Hg) were 11.5% (8.3%), 15.5% (8.3%), 13.0% (9.7%), 13.4% (13.9%), 13.5% (19.4%), and 10.6% (30.6%) at 6 months, 1 year, 2 years, 3 years, 4 years, and 5 years after the start of monotherapy, respectively. Although latanoprost demonstrated significant IOP reduction in POAG and NTG, eyes with POAG showed significant IOP reduction than those with NTG. Two eyes presented with local adverse events resulting from the discontinuation of use of latanoprost, and 4 eyes required filtering surgery.
Latanoprost stably reduced IOP over a long term and maintained visual field in approximately 70% of eyes with glaucoma after treatment for 5 years.
评估拉坦前列素单药治疗对日本青光眼患者降低眼压（IOP）的长期效果。
入组患者为在山梨大学医院青光眼门诊接受门诊治疗超过5年的青光眼患者，仅将拉坦前列素眼药水作为首选药物。接受过拉坦前列素以外的药物治疗、激光治疗或手术的受试者被排除在研究之外，以回顾性方式评估拉坦前列素降低眼压的效果、脱落率及原因，以及附加治疗的类型。
共入组72例患者（年龄：68.3±13.0岁），其中男性40例，女性32例，检查72只眼。正常眼压性青光眼（NTG）47只眼，原发性开角型青光眼（POAG）25只眼。拉坦前列素单药治疗的平均时长为4.1±2.0年（范围：5个月至7年，中位数：4.0年）。相对于拉坦前列素单药治疗开始前的平均眼压（17.8±3.4 mmHg），在单药治疗开始后6个月、1年、2年、3年、4年和5年时的眼压降低率（累积脱落率）分别为11.5%（8.3%）、15.5%（8.3%）、13.0%（9.7%）、13.4%（13.9%）、13.5%（19.4%）和10.6%（30.6%）。尽管拉坦前列素在POAG和NTG中均显示出显著的眼压降低效果，但POAG患者的眼压降低幅度显著大于NTG患者。2只眼出现因停用拉坦前列素导致的局部不良事件，4只眼需要进行滤过手术。
拉坦前列素可长期稳定降低眼压，在治疗5年后，约70%的青光眼患者的视野得以维持。
