Department of Ophthalmology, Sapporo Medical University School of Medicine , Sapporo, Japan .
J Ocul Pharmacol Ther. 2014 Feb;30(1):12-20. doi: 10.1089/jop.2013.0121. Epub 2013 Nov 28.
The purpose of the present study was to elucidate the effects of several anti-glaucoma medications on the circadian intraocular pressure (IOP) fluctuations in patients with primary open-angle glaucoma (POAG).
POAG patients (n=61; 61 eyes) with or without glaucoma medications were included. IOP measurement at 14 time points (12, 15, 18, 21, 0, 6, 9, 12, 15, 18, 21, 0, 6, and 9 o'clock) was performed over a period of 48 h. IOP changes occurring in the first 24 h and the subsequent 24 h were evaluated by several therapeutic factors.
A nocturnal acrophase pattern was observed in all the eyes with POAG. The shape of the first 24 h IOP curve was similar to that of the following 24 h IOP curves. However, there were fewer overall IOP levels in the second 24 h time period. Circadian IOP fluctuation patterns exhibited in each eye on the 1st and 2nd days were single acrophase patterns: diurnal acrophase (1st day, 54.0%; 2nd day, 60.7%) and nocturnal acrophase (1st day, 36.1%; 2nd day, 31.1%), and no single acrophase patterns: flat (1st day, 6.6%; 2nd day, 4.9%) and double acrophase (1st day, 3.3%; 2nd day, 3.3%). Among the different medication groups, a nocturnal acrophase circadian pattern was observed in the patient groups being treated by combinations of prostaglandin analog (PG) and β blocker or PG, β blocker and carbonic anhydrase inhibitor (CAI). However, this was not apparent in patient groups with or without single anti-glaucoma medications or a combination of PG and CAI.
The present study of IOP monitoring patients with POAG over a period of 48 h indicated that their changes in circadian patterns of IOP were affected by types of anti-glaucoma medications.
本研究旨在阐明几种抗青光眼药物对原发性开角型青光眼（POAG）患者昼夜眼压（IOP）波动的影响。
纳入 POAG 患者（n=61；61 眼），包括使用或未使用青光眼药物的患者。在 48 小时内的 14 个时间点（12、15、18、21、0、6、9、12、15、18、21、0、6 和 9 点钟）测量眼压。通过几个治疗因素评估前 24 小时和后 24 小时的 IOP 变化。
所有 POAG 眼均表现出夜间高峰模式。前 24 小时的 IOP 曲线形状与后 24 小时的 IOP 曲线形状相似，但后 24 小时的总体 IOP 水平较低。每只眼在第 1 天和第 2 天的昼夜 IOP 波动模式表现为单一高峰模式：日间高峰（第 1 天，54.0%；第 2 天，60.7%）和夜间高峰（第 1 天，36.1%；第 2 天，31.1%），以及无单一高峰模式：平坦（第 1 天，6.6%；第 2 天，4.9%）和双高峰（第 1 天，3.3%；第 2 天，3.3%）。在不同的药物治疗组中，接受前列腺素类似物（PG）和β受体阻滞剂联合治疗或 PG、β受体阻滞剂和碳酸酐酶抑制剂（CAI）联合治疗的患者组中观察到夜间高峰昼夜 IOP 模式。然而，在单独使用抗青光眼药物或 PG 和 CAI 联合使用的患者组中，这并不明显。
本研究对 POAG 患者进行了为期 48 小时的眼压监测，表明他们的 IOP 昼夜节律模式变化受抗青光眼药物类型的影响。
