Takemoto Daisuke, Higashide Tomomi, Saito Yoshiaki, Ohkubo Shinji, Udagawa Sachiko, Takeda Hisashi, Sugiyama Kazuhisa
Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Clin Ophthalmol. 2017 Sep 1;11:1617-1624. doi: 10.2147/OPTH.S144344. eCollection 2017.
We conducted a prospective study in patients with normal-tension glaucoma (NTG) who received either isopropyl unoprostone or latanoprost. We compared the drugs in terms of their effects on intraocular pressure (IOP) and visual field loss progression over a 3-year period.
Prospective, randomized controlled study.
We enrolled 48 patients with newly diagnosed NTG at Kanazawa University Hospital. Eligible patients were randomly allocated (1:1) to receive either unoprostone or latanoprost ophthalmic solutions. The primary outcomes were IOP changes and visual field deterioration within 36 months. Visual field changes were analyzed: the cumulative survival rates were calculated in terms of mean deviation, pattern standard deviation, and total deviation of the upper or lower hemi-visual field, each visual field sector, and guided progression analysis. In addition, we evaluated the progression of glaucomatous optic disc changes using fundus photography and confocal scanning laser ophthalmoscopy.
The mean pretreatment IOP was 15.0±2.4 mmHg in the Unoprostone group and 15.2±1.9 mmHg in the Latanoprost group. The mean IOP during the treatment period was 13.7±2.3 mmHg in the Unoprostone group and 13.0±1.8 mmHg in the Latanoprost group. In both groups, the IOP decreased significantly (<0.001) from baseline after treatment. The posttreatment IOP values were significantly lower in the Latanoprost group than in the Unoprostone group (=0.023). Regarding the 3-year cumulative survival rate of visual field loss progression, there were no significant differences between groups in any parameters of the visual field or guided progression analysis. There were no significant differences between groups in disc changes.
No significant differences were found between groups with regard to the visual field and structural progression in patients with NTG, although unoprostone was less effective than latanoprost in lowering the IOP.
我们对接受异丙前列酮或拉坦前列素治疗的正常眼压性青光眼（NTG）患者进行了一项前瞻性研究。我们比较了这两种药物在3年期间对眼压（IOP）和视野缺损进展的影响。
前瞻性随机对照研究。
我们招募了金泽大学医院48例新诊断的NTG患者。符合条件的患者被随机分配（1:1）接受异丙前列酮或拉坦前列素眼药水治疗。主要结局指标为36个月内的眼压变化和视野恶化情况。对视野变化进行分析：根据平均偏差、模式标准偏差以及上半视野或下半视野、每个视野扇区的总偏差计算累积生存率，并进行引导进展分析。此外，我们使用眼底摄影和共焦扫描激光眼科显微镜评估青光眼性视盘变化的进展情况。
异丙前列酮组治疗前平均眼压为15.0±2.4 mmHg，拉坦前列素组为15.2±1.9 mmHg。治疗期间，异丙前列酮组平均眼压为13.7±2.3 mmHg，拉坦前列素组为13.0±1.8 mmHg。两组治疗后眼压均较基线显著降低（<0.001）。拉坦前列素组治疗后眼压值显著低于异丙前列酮组（=0.023）。关于视野缺损进展的3年累积生存率，两组在视野或引导进展分析的任何参数方面均无显著差异。两组在视盘变化方面也无显著差异。
NTG患者在视野和结构进展方面，两组之间未发现显著差异，尽管异丙前列酮在降低眼压方面不如拉坦前列素有效。
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