Shimizu Yoshie, Nakakura Shunsuke, Nishiyama Makiko, Tabuchi Hitoshi, Kiuchi Yoshiaki
Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.
Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Clin Ophthalmol. 2015 Mar 11;9:475-82. doi: 10.2147/OPTH.S79680. eCollection 2015.
We investigated the efficiency, safety and patient preference of switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5% while maintaining the prostaglandin F2α analog.
We initially enrolled 44 eyes from 44 primary open angle glaucoma patients, and a total of 42 patients completed the study. All patients were under treatment with various prostaglandin F2α analogs and dorzolamide 1%/timolol 0.5%. While maintaining the prostaglandin F2α analog, dorzolamide 1%/timolol 0.5% was switched to brinzolamide 1%/timolol 0.5%. Conjunctival hyperemia, superficial punctate keratopathy, and intraocular pressure (IOP) were evaluated at baseline and at 4, 12, and 24 weeks. Adverse events and patient preferences, measured using a questionnaire at study initiation and at 24 weeks, were also noted.
The IOP was 17.7±1.7, 16.8±2.6, 16.7±2.2, and 16.7±2.4 mmHg at baseline and at 4, 12, and 24 weeks, respectively, with no significant differences in IOP values at any time point (P=0.117, one-way analysis of variance). In addition, no significant differences were found in the incidence of conjunctival hyperemia or SPK score at any time point (all P>0.5, by Kruskal-Wallis test). Based on the evaluation of side effects using the questionnaire, stinging/burning was less common (P=0.042), while blurred vision was more common (P=0.003), after switching to brinzolamide 1%/timolol 0.5%. Regarding patient preferences, 13 patients (31%) preferred dorzolamide 1%/timolol 0.5%, 12 patients (29%) preferred brinzolamide 1%/timolol 0.5%, and 17 patients (40%) preferred neither.
When switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5%, the IOP values and incidence of superficial punctate keratopathy and conjunctival hyperemia were sustained throughout the 24-week observation period, and the patient preferences were similar for the two regimens. However, differences were observed in the ocular sensations of stinging/burning with dorzolamide 1%/timolol 0.5% and blurred vision with brinzolamide 1%/timolol 0.5%.
我们研究了在维持使用前列腺素F2α类似物的同时，从1%多佐胺/0.5%噻吗洛尔转换为1%布林佐胺/0.5%噻吗洛尔的有效性、安全性及患者偏好。
我们最初纳入了44例原发性开角型青光眼患者的44只眼，共有42例患者完成了研究。所有患者均在使用各种前列腺素F2α类似物及1%多佐胺/0.5%噻吗洛尔进行治疗。在维持前列腺素F2α类似物治疗的同时，将1%多佐胺/0.5%噻吗洛尔转换为1%布林佐胺/0.5%噻吗洛尔。在基线、4周、12周和24周时评估结膜充血、浅层点状角膜炎及眼压（IOP）。还记录了在研究开始时和24周时使用问卷测量的不良事件及患者偏好。
基线时及4周、12周和24周时的眼压分别为17.7±1.7、16.8±2.6、16.7±2.2和16.7±2.4 mmHg，在任何时间点眼压值均无显著差异（P = 0.117，单因素方差分析）。此外，在任何时间点结膜充血发生率或浅层点状角膜炎评分均未发现显著差异（所有P>0.5，Kruskal-Wallis检验）。根据问卷对副作用的评估，转换为1%布林佐胺/0.5%噻吗洛尔后，刺痛/烧灼感较少见（P = 0.042），而视物模糊较常见（P = 0.003）。关于患者偏好，13例患者（31%）更喜欢1%多佐胺/0.5%噻吗洛尔，12例患者（29%）更喜欢1%布林佐胺/0.5%噻吗洛尔，17例患者（40%）两者都不喜欢。
从1%多佐胺/0.5%噻吗洛尔转换为1%布林佐胺/0.5%噻吗洛尔时，在整个24周观察期内眼压值、浅层点状角膜炎及结膜充血的发生率均保持稳定，两种治疗方案的患者偏好相似。然而，观察到使用1%多佐胺/0.5%噻吗洛尔时有刺痛/烧灼感，使用1%布林佐胺/0.5%噻吗洛尔时有视物模糊，两者在眼部感觉上存在差异。
