Gündüz Gamze Uçan, Parmak Yener Neslihan, Kılınçel Oğuzhan, Gündüz Cem
a Department of Ophthalmology , University of Health Sciences, Yüksek İhtisas Training and Research Hospital , Bursa , Turkey.
b Department of Psychiatry , Yenikent State Hospital , Sakarya , Turkey , and.
Cutan Ocul Toxicol. 2018 Mar;37(1):36-40. doi: 10.1080/15569527.2017.1330270. Epub 2017 Jun 1.
To evaluate the short- and long-term effects of selective serotonin reuptake inhibitors (SSRIs) on intraocular pressure (IOP) and anterior segment parameters in open angle eyes.
This cross-sectional study included 325 eyes of 166 subjects. Subjects were divided into three groups: Group 1 included 116 eyes of 58 patients receiving SSRIs for 1 week-6 months, Group 2 included 102 eyes of 53 patients receiving SSRIs for longer than 6 months and Group 3 included 107 eyes of 55 healthy subjects not receiving any drugs. All of the patients receiving SSRIs were diagnosed as major depressive disorder. All groups were chosen to be similar in terms of age and gender. All patients underwent a detailed ophthalmologic examination including IOP measurement by Goldmann applanation tonometer and gonioscopy. Anterior segment parameters including pupil diameter (PD), central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), and anterior chamber angle (ACA) were assessed by a Scheimpflug system.
Pupil diameter was significantly larger in patients receiving SSRIs for <6 months and ≥6 months than the control subjects (3.53 ± 0.71 mm, 3.48 ± 0.60 mm versus 3.11 ± 0.72 mm, p < 0.05) but this effect was independent from the duration of SSRI treatment. IOP was significantly lower in patients receiving SSRIs for <6 months and ≥6 months than the control group (16.04 ± 2.17 mm Hg, 16.11 ± 2.13 mm Hg versus 17.34 ± 2.15 mmHg, p < 0.05), but there were no statistically significant differences between the patients receiving SSRIs for <6 months and ≥6 months. There were no statistically significant differences between the patient and the control group in values of CCT, ACD, ACV and ACA. The ACAs were measured between 25° and 55° with Scheimpflug system and also classified as grade 3-4 (Shaffer system) by gonioscopy.
Selective serotonin reuptake inhibitors cause mydriasis which is persistent during the treatment. In depression patients with open angle eyes, short- and long-term use of SSRIs leads to decrease in IOP.
评估选择性5-羟色胺再摄取抑制剂（SSRIs）对开角型眼的眼压（IOP）和眼前节参数的短期及长期影响。
这项横断面研究纳入了166名受试者的325只眼。受试者被分为三组：第1组包括58例服用SSRIs 1周 - 6个月的患者的116只眼，第2组包括53例服用SSRIs超过6个月的患者的102只眼，第3组包括55名未服用任何药物的健康受试者的107只眼。所有服用SSRIs的患者均被诊断为重度抑郁症。所有组在年龄和性别方面选择相似。所有患者均接受了详细的眼科检查，包括使用Goldmann压平眼压计测量眼压和房角镜检查。使用Scheimpflug系统评估眼前节参数，包括瞳孔直径（PD）、中央角膜厚度（CCT）、前房深度（ACD）、前房容积（ACV）和前房角（ACA）。
服用SSRIs少于6个月和≥6个月的患者的瞳孔直径显著大于对照组（3.53±0.71mm，3.48±0.60mm对比3.11±0.72mm，p<0.05），但这种效应与SSRI治疗持续时间无关。服用SSRIs少于6个月和≥6个月的患者的眼压显著低于对照组（16.04±2.17mmHg，16.11±2.13mmHg对比17.34±2.15mmHg，p<0.05），但服用SSRIs少于6个月和≥6个月的患者之间无统计学显著差异。患者组与对照组在CCT、ACD、ACV和ACA值方面无统计学显著差异。使用Scheimpflug系统测量的前房角在25°至55°之间，并且通过房角镜检查也被分类为3 - 4级（Shaffer系统）。
选择性5-羟色胺再摄取抑制剂导致瞳孔散大，且在治疗期间持续存在。在开角型眼的抑郁症患者中，短期和长期使用SSRIs会导致眼压降低。
