Departments of Ophthalmology.
Dermatology, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo.
J Glaucoma. 2019 Apr;28(4):289-293. doi: 10.1097/IJG.0000000000001203.
Blepharitis was the most common side effect leading to discontinuation of ripasudil therapy. Prior allergic reactions to other topical glaucoma were found to be a risk factor for ripasudil-induced blepharitis.
To report the incidence proportion of blepharitis and its relating factors due to long-term use of 0.4% riapasudil, a Rho-kinase inhibitor, in glaucoma patients of a clinical setting.
One hundred three eyes of 103 consecutive glaucoma patients who started ripasudil treatment between December 2014 and February 2017 at our institute, and who had a follow-up period of over 6 months were enrolled in this study. Incidence proportion, time required for recovery and risk factors associated with blepharitis and other side effects that led to discontinuation of ripasudil treatment were considered.
The most frequently observed side effect was blepharitis (25.2%). The 12- and 24-month discontinuation rate due to blepharitis was 21.1%±8.2% and 34.6%±11.8% (average±SE), respectively (Kaplan-Meier analysis). Most patients recovered from blepharitis symptoms within 4 weeks, but 5 patients required over 8 weeks for recovery. Past history of allergic reactions to other topical glaucoma medication was significantly correlated with the manifestation of blepharitis (Cox proportional hazard model, P<0.007) while age, sex, intraocular pressure reduction rate, number of administered eye drops, history of systemic allergic diseases were not.
Blepharitis was the most common reason for discontinuation of ripasudil treatment. Although most cases were resolved spontaneously, prolonged blepharitis was observed in a few patients. A past history of allergic reaction to other glaucoma medication indicates a higher possibility of blepharitis with ripasudil use and warrants careful administration.
结膜炎是导致患者停止使用利帕舒滴眼剂的最常见原因。先前对其他局部用青光眼药物过敏被认为是利帕舒诱导的结膜炎的一个危险因素。
报告在临床环境中，使用 Rho 激酶抑制剂 0.4%利帕舒治疗青光眼患者时，因长期使用而导致结膜炎的发生率比例及其相关因素。
本研究纳入了 2014 年 12 月至 2017 年 2 月期间在我院开始利帕舒治疗的 103 例连续青光眼患者的 103 只眼，随访时间超过 6 个月。考虑了结膜炎的发生率比例、恢复所需的时间以及与结膜炎和其他导致停止利帕舒治疗的副作用相关的危险因素。
最常见的不良反应是结膜炎（25.2%）。因结膜炎导致的 12 个月和 24 个月停药率分别为 21.1%±8.2%和 34.6%±11.8%（平均±SE）（Kaplan-Meier 分析）。大多数患者的结膜炎症状在 4 周内恢复，但 5 名患者需要 8 周以上才能恢复。既往对其他局部用青光眼药物过敏的病史与结膜炎的表现显著相关（Cox 比例风险模型，P<0.007），而年龄、性别、眼压降低率、滴眼次数、全身过敏史则无相关性。
结膜炎是停止利帕舒治疗的最常见原因。尽管大多数病例是自行缓解的，但也有少数患者出现了迁延不愈的结膜炎。既往对其他青光眼药物过敏的病史表明，使用利帕舒时发生结膜炎的可能性更高，需要谨慎用药。
