Sehi Mitra, Grewal Dilraj S, Feuer William J, Greenfield David S
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, FL 33418, USA.
Vision Res. 2011 Jan 28;51(2):235-42. doi: 10.1016/j.visres.2010.08.036. Epub 2010 Sep 8.
To evaluate the impact of intraocular (IOP) reduction on retinal ganglion cell (RGC) function measured using pattern electroretinogram optimized for glaucoma (PERGLA) in glaucoma suspect and glaucomatous eyes receiving latanoprost 0.005% versus placebo.
This was a prospective, placebo-controlled, double masked, cross-over clinical trial. One randomly selected eye of each subject meeting eligibility criteria was enrolled. At each visit, subjects underwent five diurnal measurements between 8:00 am and 4:00 pm consisting of Goldmann IOP, and PERGLA measurements. A baseline examination was performed following a 4-week washout period, and repeat examination after randomly receiving latanoprost or placebo for 4-weeks. Subjects were then crossed over to receive the alternative therapy for 4 weeks following a second washout period, and underwent repeat examination. Linear mixed-effect models were used for the analysis.
Sixty-eight eyes (35 glaucoma, 33 glaucoma suspect) of 68 patients (mean age 67.4 ± 10.6 years) were enrolled. The mean IOP (mmHg) after latanoprost 0.005% therapy (14.9 ± 3.8) was significantly lower than baseline (18.8 ± 4.7, p<0.001) or placebo (18.0 ± 4.3), with a mean reduction of -20 ± 13%. Mean PERGLA amplitude (μV) and phase (π-radian) using latanoprost (0.49 ± 0.22 and 1.71 ± 0.22, respectively) were similar (p > 0.05) to baseline (0.49 ± 0.24 and 1.69 ± 0.19) and placebo (0.50 ± 0.24 and 1.72 ± 0.23). No significant (p > 0.05) diurnal variation in PERGLA amplitude was observed at baseline, or using latanoprost or placebo. Treatment with latanoprost, time of day, and IOP were not significantly (p > 0.05) associated with PERGLA amplitude or phase.
Twenty percent IOP reduction using latanoprost monotherapy is not associated with improvement in RGC function measured with PERGLA.
评估在青光眼可疑患者和青光眼患者中,使用优化用于青光眼的图形视网膜电图(PERGLA)测量,0.005%拉坦前列素与安慰剂相比,降低眼内压(IOP)对视网膜神经节细胞(RGC)功能的影响。
这是一项前瞻性、安慰剂对照、双盲、交叉临床试验。纳入符合入选标准的每个受试者的一只随机选择的眼睛。每次就诊时,受试者在上午8:00至下午4:00之间进行五次日间测量,包括Goldmann眼压测量和PERGLA测量。在4周的洗脱期后进行基线检查,并在随机接受拉坦前列素或安慰剂4周后进行重复检查。然后受试者在第二个洗脱期后交叉接受替代治疗4周,并进行重复检查。使用线性混合效应模型进行分析。
纳入了68例患者(平均年龄67.4±10.6岁)的68只眼睛(35只青光眼,33只青光眼可疑)。0.005%拉坦前列素治疗后的平均眼压(mmHg)(14.9±3.8)显著低于基线(18.8±4.7,p<0.001)或安慰剂(18.0±4.3),平均降低-20±13%。使用拉坦前列素时的平均PERGLA振幅(μV)和相位(π弧度)(分别为0.49±0.22和1.71±0.22)与基线(0.49±0.24和1.69±0.19)和安慰剂(0.50±0.24和1.72±0.23)相似(p>0.05)。在基线时,或使用拉坦前列素或安慰剂时,未观察到PERGLA振幅有显著的(p>0.05)日间变化。拉坦前列素治疗、一天中的时间和眼压与PERGLA振幅或相位无显著(p>0.05)关联。
使用拉坦前列素单药治疗使眼压降低20%与用PERGLA测量的RGC功能改善无关。