Inoue Kenji, Okayama Ryoko, Shiokawa Minako, Ishida Kyoko, Tomita Goji
Inouye Eye Hospital, 4-3 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan.
Department of Ophthalmology, Toho University Ohashi Medical Center, Ota-ku, Tokyo, Japan.
Int Ophthalmol. 2018 Feb;38(1):93-98. doi: 10.1007/s10792-016-0427-9. Epub 2017 Jan 6.
Ripasudil accelerates aqueous humour drainage along the trabecular meshwork-Schlemm's canal route and has been approved for clinical use in Japan. We retrospectively investigated the efficacy and safety of adding ripasudil to existing treatment regimens to reduce intraocular pressure (IOP) in patients with glaucoma.
A total of 119 eyes from 119 subjects (61 men, 58 women) with primary open-angle glaucoma or ocular hypertension who had ripasudil added to their treatment regimens between December 2014 and June 2015 were included. An average of 3.8 ± 1.0 anti-glaucoma medications was in use before adding ripasudil. Subjects were divided into four groups based on the number of medications included in the original treatment regimen: ≤2, 3, 4, or ≥5 medications. The IOP was compared before and after 1 and 3 months of treatment with ripasudil for all subjects and between groups. Patients for whom ripasudil use was discontinued within 3 months were also examined.
The IOP was significantly lower in all patients after 1 month (17.5 ± 4.5 mmHg) and 3 months (16.8 ± 4.2 mmHg) of treatment than it was before (19.8 ± 5.3 mmHg, p < 0.0001). All groups were equivalent in the rate and magnitude of IOP change. Ripasudil administration was discontinued in five patients (4.2%) prior to the end of the study: three were lost to follow-up and two underwent glaucoma surgery.
Adding ripasudil to existing glaucoma treatment regimens is effective and safe in reducing IOP, regardless of the number of medications in use.
ripasudil可加速房水沿小梁网-施莱姆管途径引流，已在日本获批临床使用。我们回顾性研究了在现有治疗方案中添加ripasudil以降低青光眼患者眼压的有效性和安全性。
纳入2014年12月至2015年6月期间在治疗方案中添加ripasudil的119例原发性开角型青光眼或高眼压症患者（61例男性，58例女性）的119只眼。在添加ripasudil之前，平均使用3.8±1.0种抗青光眼药物。根据原治疗方案中所含药物数量将受试者分为四组：≤2种、3种、4种或≥5种药物。比较所有受试者在使用ripasudil治疗1个月和3个月前后的眼压以及组间眼压。还对在3个月内停用ripasudil的患者进行了检查。
所有患者在治疗1个月（17.5±4.5 mmHg）和3个月（16.8±4.2 mmHg）后的眼压均显著低于治疗前（19.8±5.3 mmHg，p<0.0001）。所有组在眼压变化率和变化幅度方面相当。在研究结束前，有5例患者（4.2%）停用了ripasudil：3例失访，2例行青光眼手术。
在现有青光眼治疗方案中添加ripasudil在降低眼压方面是有效且安全的，与所用药物数量无关。
