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青光眼药物

Glaucoma medications.

作者信息

Chae Bora, Cakiner-Egilmez Tulay, Desai Manishi

机构信息

Boston University School of Medicine, Boston, MA, USA.

出版信息

Insight. 2013 Winter;38(1):5-9; quiz 10.

Abstract

Glaucoma is a common eye condition that affects millions of individuals worldwide, making it the second-leading cause of blindness. Because glaucoma is associated with increased IOP level, the primary goal in treatment of glaucoma includes lowering IOP to prevent further progression of the disease. While various surgical interventions exist, medical therapy is currently the first line of treatment. Medical treatment of glaucoma includes topical beta-blockers, alpha-2 agonists, prostaglandins, parasympathomimetics and CAIs. Anti-glaucoma agents help reduce IOP by affecting the production of aqueous humor or increasing the outflow of aqueous through the trabecular or uveoscleral pathway. Choosing an appropriate medical regimen can be challenging and various factors such as efficacy, safety, cost and patient compliance must be considered. First-line treatment is often topical beta-blockers or prostaglandin analogs. However, beta-blocking agents can be associated with systemic side effects and need to be used cautiously in patients with serious concomitant cardiopulmonary disease. Alpha-2 agonists and parasympathomimetics are often considered second- or third-line treatment options but good adjunctive agents. Oral CAIs are often indicated for patients with elevated IOP in an acute setting or for patients resistant to other glaucoma medications and patients who are not good surgical candidates.

摘要

青光眼是一种常见的眼部疾病,影响着全球数百万人,是导致失明的第二大主要原因。由于青光眼与眼压升高有关,青光眼治疗的主要目标包括降低眼压,以防止疾病进一步发展。虽然存在各种手术干预措施,但药物治疗目前是一线治疗方法。青光眼的药物治疗包括局部用β受体阻滞剂、α2激动剂、前列腺素、拟副交感神经药和碳酸酐酶抑制剂。抗青光眼药物通过影响房水生成或增加房水经小梁或葡萄膜巩膜途径的流出量来帮助降低眼压。选择合适的药物治疗方案可能具有挑战性,必须考虑各种因素,如疗效、安全性、成本和患者依从性。一线治疗通常是局部用β受体阻滞剂或前列腺素类似物。然而,β受体阻滞剂可能会伴有全身性副作用,在患有严重心肺疾病的患者中需要谨慎使用。α2激动剂和拟副交感神经药通常被视为二线或三线治疗选择,但也是很好的辅助药物。口服碳酸酐酶抑制剂通常适用于急性眼压升高的患者、对其他青光眼药物耐药的患者以及不适合手术的患者。

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