Schlote T
Augenheilkunde, Tagesklinik Ambimed, Basel, Schweiz.
Klin Monbl Augenheilkd. 2017 Feb;234(2):179-184. doi: 10.1055/s-0042-123832. Epub 2017 Jan 23.
Systemic drugs may have unfavourable effects on intraocular pressure, glaucoma and the efficacy of glaucoma drugs. The article provides a review of the literature from PubMed and clinical experience. Topical and systemic corticosteroids induce complex changes inside the trabecular meshwork. New genetic results improve the understanding of pathogenetic processes, although many questions are still open. Arterial hypertension and antihypertonic drugs may influence the risk of glaucoma, intraocular pressure and ocular perfusion pressure. Intravitreal anti-VEGF therapy may be associated with the risk of sustained intraocular pressure elevation. Systemic drugs with parasympaticolytic activity (e.g. psychopharmaceuticals) are able to induce acute angle block glaucoma. New insights into the interactions between drugs (e.g. antihypertensives, corticosteroids) and glaucomatous optic neuropathy affect large patient groups and may improve understanding of the underlying pathogenetic processes in open angle glaucoma. There is a great need for further clinical and experimental research.
全身用药可能会对眼压、青光眼及青光眼药物的疗效产生不良影响。本文回顾了来自PubMed的文献及临床经验。局部和全身使用皮质类固醇会引起小梁网内的复杂变化。尽管仍有许多问题有待解决，但新的基因研究结果增进了我们对发病机制的理解。动脉高血压和抗高血压药物可能会影响青光眼、眼压及眼灌注压的风险。玻璃体内抗VEGF治疗可能与眼压持续升高的风险相关。具有抗副交感神经活性的全身用药（如精神药物）可诱发急性闭角型青光眼。对药物（如抗高血压药、皮质类固醇）与青光眼性视神经病变之间相互作用的新认识影响着大量患者群体，并可能增进我们对开角型青光眼潜在发病机制的理解。因此，迫切需要进一步开展临床和实验研究。
