Dorofeev D A, Tur E V, Vizgalova L O, Tryapitsin I D, Ciganov A Z
Chelyabinsk City Clinical Hospital No. 2, 82 Lenina Pr., Chelyabinsk, Russian Federation, 454080.
South Ural State Medical University, 64 Vorovskogo St., Chelyabinsk, Russian Federation, 454092.
Vestn Oftalmol. 2019;135(6):52-59. doi: 10.17116/oftalma201913506152.
The goal of antihypertensive therapy is to reduce intraocular pressure (IOP). Sometimes it can only be achieved by using two or more drugs, which can lead to undesirable side effects on the ocular surface. The use of drugs that do not contain preservatives leads to fewer undesirable side effects, while also reducing the need for instillations of artificial tears, making it economically beneficial for patients.
To assess the state of ocular surface in patients with POAG when switching to preservative-free carbonic anhydrase inhibitor (ICA) containing 0.18% sodium hyaluronate in combination with prostaglandin analogues and beta-adrenergic blocking agents.
The study was conducted in 2019; according to selection criteria, it included 46 patients (80 eyes) with POAG and a control group of healthy persons. At the start of the study and one month later, after a change of treatment to uninterrupted ICA containing 0.18% sodium hyaluronate, the patients had state of their ocular surface examined: Norn's test (tear break-up time; TBUT), Schirmer's test, vital staining with lissamine green and an Ocular Surface Disease Index (OSDI) survey.
Replacing the ICA with benzalkonium chloride in the combination therapy of glaucoma with a preservative-free ICA containing 0.18% sodium hyaluronate - Dorzolan Solo (Solopharm, Russia) - expectedly did not lead to additional decrease of IOP, but resulted in a decrease in the width of the confidence interval according to both Maklakov's and Icare tonometers, which may be associated with increased treatment adherence. At the same time, the state of ocular surface in the observation group was statistically significantly improved according to Norn's test - from 3.57±1.3; 3.0 (3.0; 5.0) to 4.9±2.5; 5.0 (3.0; 6.0) (V=16.5; p=0.0039).
According to Schirmer's test and vital staining with lissamine green, no statistically significant changes have occurred. OSDI survey did not reveal changes in the study patients during 4 weeks of the follow-up, while the control group exhibited improvement.
抗高血压治疗的目标是降低眼压（IOP）。有时只能通过使用两种或更多种药物才能实现，这可能会对眼表产生不良副作用。使用不含防腐剂的药物会减少不良副作用，同时也减少了人工泪液滴眼的需求，对患者来说在经济上是有益的。
评估原发性开角型青光眼（POAG）患者改用含0.18%透明质酸钠的无防腐剂碳酸酐酶抑制剂（ICA）联合前列腺素类似物和β-肾上腺素能阻滞剂时的眼表状态。
该研究于2019年进行；根据入选标准，纳入了46例POAG患者（80只眼）和一个健康人对照组。在研究开始时以及一个月后，在改用含0.18%透明质酸钠的不间断ICA治疗后，对患者的眼表状态进行检查：诺恩试验（泪膜破裂时间；TBUT）、施密特试验、丽丝胺绿活体染色和眼表疾病指数（OSDI）调查。
在青光眼联合治疗中，用含0.18%透明质酸钠的无防腐剂ICA（多佐胺单剂，俄罗斯索洛制药公司）替代含苯扎氯铵的ICA，预期不会导致眼压进一步降低，但根据马克拉科夫眼压计和Icare眼压计，置信区间宽度减小，这可能与治疗依从性提高有关。同时，根据诺恩试验，观察组的眼表状态有统计学显著改善——从3.57±1.3；3.0（3.0；5.0）变为4.9±2.5；5.0（3.0；6.0）（V=16.5；p=0.0039）。
根据施密特试验和丽丝胺绿活体染色，未发生统计学显著变化。OSDI调查未发现研究患者在随访4周期间有变化，而对照组有所改善。
