Chihara Etsuo, Dimitrova Galina, Chihara Tomoyuki
Sensho-kai Eye Institute, Minamiyama 50-1, Iseda, Uji, Kyoto, 611-0043, Japan.
Department of Ophthalmology, City General Hospital 8th September, Skopje, Macedonia.
Graefes Arch Clin Exp Ophthalmol. 2018 Jul;256(7):1257-1264. doi: 10.1007/s00417-018-3945-5. Epub 2018 Mar 8.
To assess the responses of the superficial peripapillary retinal vessel density (VD) and prelaminar flow index (PLFI) to topical Rho-assisted coiled-coil forming protein kinase (ROCK) inhibitor ripasudil and alpha-2 agonist brimonidine using optical coherence tomography angiography.
This is a prospective, non-randomized, comparative cohort study. We studied the response of optical coherence tomography angiography (OCTA) parameters to drugs in 24 eyes treated with ripasudil and 23 eyes treated with brimonidine at the Sensho-kai Eye Institute. After division by the signal strength (SS), we compared the responses of peripapillary VD/SS and PLFI/unit area (UA)/SS to topical eye drops in eyes with primary open-angle glaucoma (POAG) and ocular hypertension (OH).
In the superficial peripapillary retina, VD/SS increased significantly in the ripasudil-treated eyes (12.5 ± 21.7%, P = 0.018), but not in the brimonidine-treated eyes (- 2.0 ± 13.8%, P = 0.484). In the deeper area of the optic disc, the changes in the PLFI/UA/SS in the brimonidine-treated eyes (+ 0.9 ± 8.9%, P = 1.00) and ripasudil-treated eyes (- 1.3 ± 8.5%, P = 0.241) were not significant. Multivariate discriminant analysis showed that the change in the peripapillary VD/SS was the most important parameter (P = 0.0186) for differentiating ripasudil- and brimonidine-treated eyes.
The topical ROCK inhibitor ripasudil enhanced the peripapillary VD in POAG and OH, whereas the alpha-2 agonist brimonidine did not. The PLFI did not respond to either drug.
使用光学相干断层扫描血管造影术评估视乳头周围视网膜浅层血管密度（VD）和板层前血流指数（PLFI）对局部应用Rho辅助卷曲螺旋形成蛋白激酶（ROCK）抑制剂ripasudil和α-2激动剂溴莫尼定的反应。
这是一项前瞻性、非随机、比较性队列研究。我们在Sensho-kai眼科研究所研究了光学相干断层扫描血管造影（OCTA）参数对24只接受ripasudil治疗的眼睛和23只接受溴莫尼定治疗的眼睛中药物的反应。按信号强度（SS）划分后，我们比较了原发性开角型青光眼（POAG）和高眼压症（OH）患者眼中视乳头周围VD/SS和PLFI/单位面积（UA）/SS对局部滴眼液的反应。
在视乳头周围视网膜浅层，ripasudil治疗组的眼睛VD/SS显著增加（12.5±21.7%，P = 0.018），而溴莫尼定治疗组的眼睛则没有增加（-2.0±13.8%，P = 0.484）。在视盘较深区域，溴莫尼定治疗组眼睛（+0.9±8.9%，P = 1.00）和ripasudil治疗组眼睛（-1.3±8.5%，P = 0.241）的PLFI/UA/SS变化不显著。多变量判别分析表明，视乳头周围VD/SS的变化是区分ripasudil和溴莫尼定治疗组眼睛的最重要参数（P = 0.0186）。
局部应用ROCK抑制剂ripasudil可提高POAG和OH患者视乳头周围的VD，而α-2激动剂溴莫尼定则不能。PLFI对两种药物均无反应。
