Acar Yeliz, Eltutar Kadir, Zırtıloğlu Sibel
İstanbul Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey.
Turk J Ophthalmol. 2017 Aug;47(4):186-191. doi: 10.4274/tjo.45336. Epub 2017 Aug 15.
To evaluate and compare anterior segment changes in patients taking alpha-1 (α1) blockers (tamsulosin, terazosin, doxazosin, alfuzosin) for benign prostatic hypertrophy, during drug intake and drug-free period, using ultrasound biomicroscopy (UBM).
In this prospective study, UBM was done before and after pupil dilatation in 31 phakic eyes of 19 male patients taking α1-blockers. Undilated and dilated UBM was repeated before cataract extraction, after stopping the drug for 10 days. On ideal images, pupil diameter (PD), anterior chamber depth (ACD), anterior chamber angle (ACA), and angle opening distances at points 500 µm and 250 µm from the scleral spur (AOD500 and AOD250) values were noted and changes in parameters were evaluated to reveal any changes that occurred after discontinuing the drug. No patient in the study was previously or currently using any other α1-adrenergic antagonist medication. Exclusion criteria for all patients included a history of diabetes mellitus, systemic hypertension, glaucoma, pseudoexfoliation syndrome, chronic use of medicated eye drops, and previous ocular surgery.
PD, ACD, ACA, AOD500 and AOD250 values measured before pupil dilatation in the drug-free period were not significantly different from those measured during α-blocker intake (p>0.05). In dilated eyes, the mean value of AOD500 was 0.35±0.08 mm during drug usage and 0.39±0.08 mm in the drug-free period. The mean value of AOD250 was 0.23±0.06 mm during drug usage and 0.26±0.07 mm after discontinuation. These increments were statistically significant (p<0.05, z=-3.699, z=-2.984). On the other hand, there were no significant differences in ACD, ACA, or PD values in dilated eyes after discontinuing α1-blockers (p>0.05).
The interruption of taking α1-blockers in patients who have benign prostatic hypertrophy does not seem to influence anterior segment parameters generally. However, further investigation is needed.
使用超声生物显微镜（UBM）评估和比较服用α1受体阻滞剂（坦索罗辛、特拉唑嗪、多沙唑嗪、阿夫唑嗪）治疗良性前列腺增生的患者在服药期间和停药期眼前节的变化。
在这项前瞻性研究中，对19例服用α1受体阻滞剂的男性患者的31只晶状体眼在散瞳前后进行UBM检查。在白内障摘除术前，停药10天后重复进行未散瞳和散瞳状态下的UBM检查。在理想图像上，记录瞳孔直径（PD）、前房深度（ACD）、前房角（ACA）以及距巩膜突500μm和250μm处的房角开放距离（AOD500和AOD250）值，并评估参数变化以揭示停药后发生的任何变化。该研究中没有患者之前或目前正在使用任何其他α1肾上腺素能拮抗剂药物。所有患者的排除标准包括糖尿病史、系统性高血压、青光眼、假性剥脱综合征、长期使用眼药水以及既往眼部手术史。
在停药期未散瞳时测量的PD、ACD、ACA、AOD500和AOD250值与服用α受体阻滞剂期间测量的值无显著差异（p>0.05）。在散瞳眼中，用药期间AOD500的平均值为0.35±0.08mm，停药期为0.39±0.08mm。用药期间AOD250的平均值为0.23±0.06mm，停药后为0.26±0.07mm。这些增加具有统计学意义（p<0.05，z=-3.699，z=-2.984）。另一方面，停用α1受体阻滞剂后散瞳眼中的ACD、ACA或PD值无显著差异（p>0.05）。
良性前列腺增生患者停用α1受体阻滞剂似乎一般不会影响眼前节参数。然而，仍需要进一步研究。
