Wy Seoyoung, Kim Young Kook, Jeoung Jin Wook, Park Ki Ho, Ha Ahnul
Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2020 Feb;34(1):19-26. doi: 10.3341/kjo.2019.0094.
We sought to compare the efficacy as well as the safety of two maximum medical therapy combinations applied to lower the intraocular pressure (IOP) in different primary open-angle glaucoma (POAG) age groups.
This was a retrospective, consecutive case series study that included 60 eyes of 60 subjects with POAG, specifically 20 subjects aged 40 to 54 years, 21 aged 55 to 69 years, and 19 aged 70 years or older. All had been treated for at least 12 months with triple maximum medical therapy (TMT; dorzolamide/timolol, brimonidine, and latanoprost) to lower their IOP, which subsequently was changed to double maximum medical therapy (DMT, fixed drug combinations of tafluprost/timolol and brinzolamide/brimonidine). The rate of IOP change and adverse drug reactions were compared amongst the three age groups.
The mean IOP change at three months after converting from TMT to DMT was -0.65 ± 1.42 mmHg (-3.84% ± 9.31%) among the overall study group, but this finding was not statistically significant ( = 0.108). In the 40 to 54 years and 55 to 69 years groups, the mean IOP change rates were +0.29 ± 0.96 mmHg (+2.40% ± 6.85%, = 0.087) and -0.50 ± 0.99 mmHg (-3.05% ± 6.40%, = 0.084) respectively. In the 70 years or older group, the mean IOP change, interestingly, was -1.80 ± 1.46 mmHg (-11.29% ± 9.31%, < 0.001) and nine (47.4%) of the 19 subjects showed additional IOP reductions of 10% or more after converting from TMT to DMT. In all three age groups, the incidence rate of dry eye was significantly lower for DMT than for TMT ( = 0.031).
In POAG patients, DMT was proven to be both effective and safe for lowering the IOP, especially in those 70 years or older group, when compared with the TMT protocol.
我们试图比较两种最大剂量药物联合治疗方案在不同原发性开角型青光眼（POAG）年龄组中降低眼压（IOP）的疗效和安全性。
这是一项回顾性、连续性病例系列研究，纳入了60例POAG患者的60只眼，具体为20例年龄在40至54岁之间，21例年龄在55至69岁之间，19例年龄在70岁及以上。所有患者均接受了至少12个月的三联最大剂量药物治疗（TMT；多佐胺/噻吗洛尔、溴莫尼定和拉坦前列素）以降低眼压，随后改为双联最大剂量药物治疗（DMT，固定药物组合为他氟前列素/噻吗洛尔和布林佐胺/溴莫尼定）。比较三个年龄组之间的眼压变化率和药物不良反应。
在整个研究组中，从TMT转换为DMT后三个月的平均眼压变化为-0.65±1.42 mmHg（-3.84%±9.31%），但这一结果无统计学意义（P = 0.108）。在40至54岁组和55至69岁组中，平均眼压变化率分别为+0.29±0.96 mmHg（+2.40%±6.85%，P = 0.087）和-0.50±0.99 mmHg（-3.05%±6.40%，P = 0.084）。有趣的是，在70岁及以上组中，平均眼压变化为-1.80±1.46 mmHg（-11.29%±9.31%，P < 0.001），19例患者中有9例（47.4%）在从TMT转换为DMT后眼压额外降低了10%或更多。在所有三个年龄组中，DMT的干眼发病率均显著低于TMT（P = 0.031）。
在POAG患者中，与TMT方案相比，DMT被证明在降低眼压方面既有效又安全，尤其是在70岁及以上组。
