Lee Jacky W Y, Liu Catherine C L, Chan Jonathan C H, Lai Jimmy S M
From the Department of Ophthalmology, Caritas Medical Centre, (JWYL); The Department of Ophthalmology, The University of Hong Kong, (JWYL, JSML); Department of Applied Mathematics, The Hong Kong Polytechnic University (CCLL); and The Department of Ophthalmology, Queen Mary Hospital, Hong Kong, SAR, People's Republic of China (JCHC).
Medicine (Baltimore). 2014 Dec;93(28):e236. doi: 10.1097/MD.0000000000000236.
To determine the predictors of success for selective laser trabeculoplasty (SLT) in normal tension glaucoma (NTG). This prospective cohort study recruited subjects with unilateral or bilateral NTG on medication. All subjects received a single session of 360° SLT treatment. SLT success was defined as IOP reduction≥20% at 1-month. The following covariates were analyzed via univariate and multivariate analyses: age; sex; lens status; presenting, pre-SLT, and post-SLT IOP's; number and type of medications; SLT shots and energy; and pre-SLT investigations. In 60 eyes of 32 subjects with NTG, there were 30 right eyes and 28 left eyes. The success rate of SLT was 61.7%. Using 3 types of anti-glaucoma medications (coefficient=-2.2, OR=0.1, P=0.02) and a thicker retinal nerve fiber layer thickness (coefficient=-0.04, OR=0.96, P=0.04) were associated with failure (univariate analysis). In multivariate analysis, a higher pre-SLT IOP (coefficient=1.1, OR=3.1, P=0.05) and a lower 1-week IOP (coefficient=-0.8, OR=0.5, P=0.04) were associated with success. SLT was successful in over 60% of treated NTG patients. A higher pre-SLT IOP and a greater IOP reduction at 1-week post-SLT were predictors of a successful outcome.
确定正常眼压性青光眼(NTG)患者选择性激光小梁成形术(SLT)成功的预测因素。这项前瞻性队列研究招募了正在使用药物治疗的单侧或双侧NTG患者。所有受试者均接受了一次360°SLT治疗。SLT成功定义为1个月时眼压降低≥20%。通过单因素和多因素分析对以下协变量进行分析:年龄;性别;晶状体状态;就诊时、SLT术前和术后的眼压;药物的数量和类型;SLT的激光脉冲次数和能量;以及SLT术前的检查。在32例NTG患者的60只眼中,右眼30只,左眼28只。SLT的成功率为61.7%。使用3种抗青光眼药物(系数=-2.2,OR=0.1,P=0.02)和较厚的视网膜神经纤维层厚度(系数=-0.04,OR=0.96,P=0.04)与失败相关(单因素分析)。在多因素分析中,较高的SLT术前眼压(系数=1.1,OR=3.1,P=0.05)和较低的1周眼压(系数=-0.8,OR=0.5,P=0.04)与成功相关。超过60%的NTG治疗患者SLT成功。较高的SLT术前眼压和SLT术后1周更大的眼压降低是成功结果的预测因素。