Takeda Sakurako, Mimura Tatsuya, Matsubara Masao
Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan ; Department of Ophthalmology, Nippori Clinic, Medical Center East, Tokyo Women's Medical University, Tokyo, Japan.
Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
Clin Ophthalmol. 2014 Aug 25;8:1579-90. doi: 10.2147/OPTH.S71162. eCollection 2014.
To evaluate the effect of treatment for 3 years with a dorzolamide/timolol (1%/0.5%) fixed combination (DTFC) on visual field progression in patients with open-angle glaucoma.
A total of 14 consecutive patients were enrolled who had been previously treated with monotherapy or any combination of a beta blocker, carbonic anhydrase inhibitor, and/or prostaglandin analog for primary open-angle glaucoma (POAG; n=4) or normal-tension glaucoma (NTG; n=10).
Patients were switched to DTFC from their prior glaucoma therapy. The IOP was measured at intervals of 4-6 weeks, and the visual fields were examined at least twice a year for 3 years. The annual change of mean deviation (MD slope) was used to quantify visual field loss.
The mean MD value was -5.9±5.0 dB at baseline; it was -5.6±4.8 dB at 12 months, -5.9±5.0 dB at 24 months, and -5.6±5.1 dB at 36 months after switching. The mean MD slope was -0.2±0.8 dB/year before switching and 0.3±1.3 dB/year from baseline to 1 year, -0.3±1.1 dB/year from 1-2 years, and 0.3±0.9 dB/year from 2-3 years after switching. The mean MD slope from baseline to 36 months was correlated with the IOP reduction rate at 36 months after switching. Visual field progression was associated with the IOP reduction rate at 12 months after switching.
Switching to DTFC from prior glaucoma therapy improved the MD slope for at least 3 years. Reduction of the IOP after switching to DTFC was effective for delaying visual field progression. Although our study was not nonrandomized and was small in scale, the findings suggest that DTFC might have a beneficial effect on the visual fields in patients with open-angle glaucoma.
评估用多佐胺/噻吗洛尔（1%/0.5%）固定复方制剂（DTFC）治疗3年对开角型青光眼患者视野进展的影响。
共纳入14例连续患者，这些患者此前曾接受单一疗法或β受体阻滞剂、碳酸酐酶抑制剂和/或前列腺素类似物的任何组合治疗原发性开角型青光眼（POAG；n = 4）或正常眼压性青光眼（NTG；n = 10）。
患者从先前的青光眼治疗方案转换为DTFC治疗。眼压每隔4 - 6周测量一次，视野每年至少检查两次，共检查3年。用平均偏差（MD斜率）的年度变化来量化视野损失。
转换治疗前基线时平均MD值为 -5.9±5.0 dB；转换治疗后12个月时为 -5.6±4.8 dB，24个月时为 -5.9±5.0 dB，36个月时为 -5.6±5.1 dB。转换治疗前平均MD斜率为 -0.2±0.8 dB/年，从基线到1年为0.3±1.3 dB/年，从第1 - 2年为 -0.3±1.1 dB/年，从第2 - 3年为0.3±0.9 dB/年。从基线到36个月的平均MD斜率与转换治疗后36个月时的眼压降低率相关。视野进展与转换治疗后12个月时的眼压降低率相关。
从先前的青光眼治疗方案转换为DTFC治疗至少3年改善了MD斜率。转换为DTFC治疗后眼压降低对延缓视野进展有效。尽管我们的研究并非非随机且规模较小，但研究结果表明DTFC可能对开角型青光眼患者的视野有有益影响。
