Department of Ophthalmology, Jichi Medical University, Tochigi, Japan.
Department of Ophthalmology, Jichi Medical University, Tochigi, Japan; Department of Ophthalmology, Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan.
Am J Ophthalmol. 2019 Oct;206:11-16. doi: 10.1016/j.ajo.2019.03.013. Epub 2019 Mar 20.
To investigate changes in the interpupillary distance (IPD) after continual instillation of topical prostaglandin analogs (PGAs) in glaucoma patients as an objective indicator of prostaglandin-associated periorbitopathy (PAP).
Retrospective, comparative case series.
A total of 152 institutional patients with glaucoma were enrolled in this study. Inclusion criteria were visual acuities exceeding 10/20 bilaterally and no intraocular surgery during observation. Intervention/observation procedures: First-time bilateral instillation of bimatoprost, travoprost, latanoprost, or tafluprost and IPDs measured by automatic refractometry. IPDs, intraocular pressures (IOPs), and refractive errors were measured before and after continual drug administration (treatment, 2-24 months).
Post-treatment changes in IPDs. A total of 61 untreated patients served as controls.
The IPDs shortened significantly (P < 0.001) after treatment (-0.80 ± 2.1 mm); the IPDs of control subjects remained unchanged (0.05 ± 0.96 mm; P = 0.69). The IPD change after bimatoprost instillation (-2.20 ± 0.97 mm) was significantly (P < 0.001) greater than with other PGAs (-0.65 ± 2.09 mm). The IOPs decreased significantly (P < 0.001) (-3.7 ± 4.3 mm Hg); the refractive errors did not change significantly (P < 0.099) (-0.07 ± 0.69 diopter) post-treatment. The percentages of subjects with 2-mm or greater decreases in IPD after bimatoprost, travoprost, latanoprost, or tafluprost were 85.7%, 20.0%, 18.2%, and 17.2%, respectively, and with 3-mm or greater decreases in IPD 35.7%, 12.0%, 14.5%, and 12.1%, respectively. The specificities were 93.4% and 100% in the control group, respectively, with IPD threshold changes of 2 and 3 mm or more, respectively.
The IPD decreased significantly after topical PGAs within 24 months. The effect was significantly greater with bimatoprost than with other PGAs. The noninvasive, immediate automatic refractometry measurement may be an objective numerical indicator of PAP.
研究连续局部使用前列腺素类似物（PGAs）治疗青光眼患者的瞳孔间距（IPD）变化，作为与前列腺素相关的眶周病（PAP）的客观指标。
回顾性、对照病例系列研究。
本研究共纳入 152 名机构性青光眼患者。入选标准为双眼视力均超过 10/20，且观察期间无眼内手术。干预/观察程序：首次双眼给予比马前列素、曲伏前列素、拉坦前列素或他氟前列素滴眼，并采用自动折射仪测量 IPD。在持续药物治疗前（治疗 2-24 个月）和治疗后测量 IPD、眼内压（IOP）和屈光不正。
治疗后 IPD 的变化。共 61 名未治疗患者作为对照。
治疗后 IPD 明显缩短（P < 0.001）（-0.80 ± 2.1mm）；对照组 IPD 无变化（0.05 ± 0.96mm；P = 0.69）。比马前列素滴眼后 IPD 变化（-2.20 ± 0.97mm）明显大于其他 PGAs（-0.65 ± 2.09mm）（P < 0.001）。IOP 明显下降（P < 0.001）（-3.7 ± 4.3mmHg）；治疗后屈光不正无明显变化（P < 0.099）（-0.07 ± 0.69 屈光度）。比马前列素、曲伏前列素、拉坦前列素和他氟前列素滴眼后 IPD 减少 2mm 或以上的患者比例分别为 85.7%、20.0%、18.2%和 17.2%，减少 3mm 或以上的患者比例分别为 35.7%、12.0%、14.5%和 12.1%。对照组 IPD 阈值变化 2mm 或 3mm 或以上时，特异性分别为 93.4%和 100%。
在 24 个月内，局部使用 PGAs 后 IPD 明显缩短。比马前列素的效果明显大于其他 PGAs。非侵入性、即时自动折射测量法可能是 PAP 的客观数值指标。
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