Williamson J, Young J D, Atta H, Muir G, Kadom H
Br J Ophthalmol. 1985 Jan;69(1):41-5. doi: 10.1136/bjo.69.1.41.
This open study of beta blockers in chronic simple glaucoma compared the efficacy of once daily (o.d.) oral nadolol therapy with twice daily (b.d.) topical timolol therapy. Sixty eight patients were randomly assigned to starting doses of either 20, 40, or 80 mg of nadolol o.d. (51 patients) or 0.25% timolol b.d. (17 patients) and were seen at weekly intervals for a four-week (short-term) period. Upward dosage titration (80 mg o.d. maximum, nadolol and 0.5% b.d. maximum, timolol) was permitted if, at any visit, the intraocular pressure (IOP) in either eye was greater than 21 mmHg. At the end of 4 weeks the IOPs of a comparable number of patients were controlled (IOP less than 22 mmHg) with 20 mg nadolol o.d. and 0.25% timolol b.d. The 40 mg and 80 mg o.d. nadolol regimens were comparable with each other, superior to the 20 mg regimen, and (at least) equivalent to 0.5% timolol. The absolute degree of IOP reduction achieved with oral nadolol was equivalent to that with topical timolol. Alterations in blood pressure and heart rate were predictably greater with the orally administered beta blocker. Long-term therapy (up to 24 months) in 28 nadolol patients and 5 timolol patients indicates no more likelihood of tolerance with nadolol therapy. Patient withdrawals from the study due to adverse reactions occurred with nadolol but not timolol. Since oral nadolol administered once daily is as efficacious as b.d. topical timolol, it can be recommended as first-line therapy for certain subsets of the glaucoma clinic population.
这项关于β受体阻滞剂治疗慢性单纯性青光眼的开放性研究，比较了每日一次口服纳多洛尔疗法与每日两次局部用噻吗洛尔疗法的疗效。68例患者被随机分配开始服用20、40或80毫克每日一次的纳多洛尔（51例患者）或0.25%每日两次的噻吗洛尔（17例患者），并在为期四周的短期时间内每周就诊一次。如果在任何一次就诊时，任一眼的眼压（IOP）大于21毫米汞柱，则允许向上调整剂量（纳多洛尔最大剂量为每日一次80毫克，噻吗洛尔最大剂量为每日两次0.5%）。4周结束时，服用20毫克每日一次纳多洛尔和0.25%每日两次噻吗洛尔的相当数量患者的眼压得到控制（眼压低于22毫米汞柱）。每日一次40毫克和80毫克纳多洛尔方案彼此相当，优于20毫克方案，且（至少）等同于0.5%噻吗洛尔。口服纳多洛尔降低眼压的绝对程度与局部用噻吗洛尔相当。口服β受体阻滞剂导致的血压和心率变化可预测地更大。对28例纳多洛尔患者和5例噻吗洛尔患者进行的长达24个月的长期治疗表明，纳多洛尔治疗产生耐受性的可能性并不更高。因不良反应退出研究的情况在纳多洛尔组出现，而噻吗洛尔组未出现。由于每日一次口服纳多洛尔与每日两次局部用噻吗洛尔疗效相同，对于青光眼门诊患者的某些亚组，可推荐其作为一线治疗。
