Imasawa Mitsuhiro, Tanabe Joji, Kashiwagi Fumiko, Kashiwagi Kenji
Department of Ophthalmology, Nirasaki Municipal Hospital, Nirasaki, Yamanashi, Japan; Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan.
Tanabe Eye Clinic, Kai, Yamanashi, Japan.
Open Ophthalmol J. 2016 Mar 7;10:94-102. doi: 10.2174/1874364101610010094. eCollection 2016.
To prospectively assess the efficacy and safety of switching to bimatoprost monotherapy or brinzolamide and latanoprost combination therapy in patients who had been receiving latanoprost monotherapy.
A prospective, open-label study was conducted. Patients with primary open-angle glaucoma or ocular hypertension who had been receiving latanoprost monotherapy for three months or more were enrolled. Bimatoprost was substituted for latanoprost in one eye (BIM group), and brinzolamide was added to the latanoprost in the other eye (BRZ group) simultaneously. The patients underwent examinations at 6 weeks (visit 1) and 12 weeks (visit 2) after changing therapies. Subsequently, the treatments were returned to latanoprost monotherapy. The patients underwent another examination 6 weeks (visit 3) after the return to latanoprost. The parameters examined were intraocular pressure (IOP), conjunctival hyperemia, and corneal epithelial damage.
Twenty-six patients (13 men and 13 women) completed the protocol. Both groups showed a significant IOP reduction at visits 1 and 2 compared with the baseline, with a similar magnitude (BIM group: P = 0.016 at visit 1, P = 0.025 at visit 2, BRZ group: P = 0.0006 at visit 1, P = 0.028 at visit 2). The IOPs at the baseline and on visit 3 were similar in both groups (P = 0.7). The two groups showed no changes in either conjunctival hyperemia or corneal epithelial damage compared with the baseline.
Bimatoprost monotherapy and brinzolamide adjunctive to latanoprost similarly reduced the IOP, with no additive adverse effects, compared with latanoprost monotherapy.
前瞻性评估在接受拉坦前列素单药治疗的患者中转换为比马前列素单药治疗或布林佐胺与拉坦前列素联合治疗的疗效和安全性。
进行了一项前瞻性、开放标签研究。纳入接受拉坦前列素单药治疗三个月或更长时间的原发性开角型青光眼或高眼压症患者。一只眼睛用比马前列素替代拉坦前列素（BIM组），另一只眼睛在拉坦前列素基础上加用布林佐胺（BRZ组）。患者在改变治疗后6周（访视1）和12周（访视2）进行检查。随后，恢复拉坦前列素单药治疗。患者在恢复拉坦前列素治疗6周后（访视3）再次进行检查。检查的参数包括眼压（IOP）、结膜充血和角膜上皮损伤。
26例患者（13例男性和13例女性）完成了方案。与基线相比，两组在访视1和访视2时眼压均显著降低，降低幅度相似（BIM组：访视1时P = 0.016，访视2时P = 0.025；BRZ组：访视1时P = 0.0006，访视2时P = 0.028）。两组在基线和访视3时的眼压相似（P = 0.7）。与基线相比，两组结膜充血和角膜上皮损伤均无变化。
与拉坦前列素单药治疗相比，比马前列素单药治疗和拉坦前列素联合布林佐胺治疗降低眼压的效果相似，且无附加不良反应。
