1 Department of Ophthalmology, Faculty of Medicine, Uludag University , Bursa, Turkey .
2 Department of Ophthalmology, Yuksek Ihtisas Training and Research Hospital, University of Health Sciences , Bursa, Turkey .
J Ocul Pharmacol Ther. 2018 May;34(4):354-359. doi: 10.1089/jop.2017.0133. Epub 2018 Feb 15.
To evaluate anterior segment parameters and intraocular pressure (IOP) modifications in patients using serotonin noradrenaline reuptake inhibitors (SNRIs) due to major depressive disorder.
This cross-sectional study included 170 eyes of 85 subjects. All subjects were divided into three groups: group 1 included 44 healthy control subjects, group 2 included 22 patients receiving antidepressants for 1 week to 6 months, and group 3 included 19 patients receiving antidepressants for >6 months. All subjects underwent a detailed ophthalmologic examination, including gonioscopy. Anterior segments of all subjects were evaluated with the Scheimpflug system and pupil diameter (PD), central corneal thickness, anterior chamber depth (ACD), anterior chamber volume, and anterior chamber angle (ACA) measurements were enrolled.
The median IOP was significantly lower in patients using antidepressants [16.0 (11.0-21.0) mmHg] than the control group [17.5 (12.0-21.0) mmHg] (P = 0.041). The PD was significantly larger in patients using antidepressants [3.56 (2.29-5.60) mm] than the control group [2.95 (2.00-4.40) mm] (P = 0.000). In the study group, PD was also significantly larger in patients using SNRIs for ≥6 months [3.67 (2.38-5.08) mm] than <6 months [3.31 (2.29-5.60) mm] (P = 0.000). The median ACD was significantly lower in patients using antidepressants for ≥6 months [3.21 (2.52-4.06) mm] than the control group [3.44 (2.63-4.29) mm] (P = 0.000). ACAs were measured between 25° and 55° by Scheimpflug imaging.
Treatment of SNRIs causes mydriasis and decrease in width of ACD. These changes may not increase IOP as long as the patient has an open angle. SNRIs lead to decrease in IOP particularly in long-term usage.
评估因重度抑郁症而使用血清素去甲肾上腺素再摄取抑制剂 (SNRIs) 的患者的眼前节参数和眼内压 (IOP) 变化。
这是一项横断面研究，共纳入了 85 名患者的 170 只眼。所有患者分为三组：第 1 组包括 44 名健康对照者，第 2 组包括 22 名接受抗抑郁治疗 1 周至 6 个月的患者，第 3 组包括 19 名接受抗抑郁治疗 >6 个月的患者。所有患者均接受详细的眼科检查，包括房角镜检查。使用 Scheimpflug 系统评估所有患者的眼前节，记录瞳孔直径 (PD)、中央角膜厚度、前房深度 (ACD)、前房容积和前房角 (ACA) 测量值。
使用抗抑郁药的患者的中位 IOP[16.0（11.0-21.0）mmHg]明显低于对照组[17.5（12.0-21.0）mmHg]（P=0.041）。使用抗抑郁药的患者的 PD[3.56（2.29-5.60）mm]明显大于对照组[2.95（2.00-4.40）mm]（P=0.000）。在研究组中，使用 SNRIs 治疗≥6 个月的患者的 PD[3.67（2.38-5.08）mm]也明显大于<6 个月的患者[3.31（2.29-5.60）mm]（P=0.000）。使用抗抑郁药治疗≥6 个月的患者的中位 ACD[3.21（2.52-4.06）mm]明显低于对照组[3.44（2.63-4.29）mm]（P=0.000）。Scheimpflug 成像测量的 ACA 在 25°至 55°之间。
SNRIs 的治疗会导致瞳孔散大，ACD 变窄。只要患者具有开放的房角，这些变化就不会导致眼压升高。SNRIs 尤其会导致长期使用后眼压降低。
