Department of Ophthalmology, Juntendo Tokyo-Koto Geriatric Medical Center, Juntendo University School of Medicine, Shinsuna 3-3-20, Koto-ku, Tokyo, 136-0075, Japan.
Marumoto Eye Clinic, Yokohama, Kanagawa, Japan.
Int Ophthalmol. 2021 Feb;41(2):605-611. doi: 10.1007/s10792-020-01615-x. Epub 2020 Oct 20.
To compare the intraocular pressure (IOP)-lowering effects of ripasudil, a rho-kinase inhibitor, and selective laser trabeculoplasty (SLT) as adjuvant therapy in Japanese glaucoma patients and to identify the factors associated with treatment success.
We performed a retrospective medical chart review of patients with glaucoma who received ripasudil or SLT as an adjuvant therapy. We collected data on 65 eyes (65 patients) with primary open-angle glaucoma, normal-tension glaucoma, or exfoliation glaucoma with at least 12 months of follow-up. IOP and number of glaucoma medications at 0, 1, 3, 6, 9, and 12 months were compared between and within groups. A repeated-measures mixed model was used to perform statistical analysis. We also investigated factors associated with treatment success, which was defined as ≥ 20% reduction in IOP at all follow-up periods, using univariate and multivariate logistic regression analysis.
Significant IOP reduction was observed at all time-points after treatment in the ripasudil group (n = 33) and in the SLT group (n = 32), with no statistically significant difference between the groups before or after treatment. Patients in the SLT group used more anti-glaucoma medications before treatment, but fewer during follow-up, than those in the ripasudil group. Regardless of treatment, higher baseline IOP was associated with treatment success [crude odds ratio: 1.21 (95% confidence interval: 1.06-1.38), adjusted odds ratio: 1.37 (95% confidence interval: 1.06-1.77)].
Adjuvant SLT or ripasudil in patients with inadequately controlled glaucoma both reduced IOP to a similar degree, but SLT contributed to reducing the number of medications used.
比较 rho 激酶抑制剂利匹司特和选择性激光小梁成形术（SLT）作为辅助治疗在日本青光眼患者中的降眼压效果，并确定与治疗成功相关的因素。
我们对接受利匹司特或 SLT 辅助治疗的青光眼患者进行了回顾性病历审查。我们收集了至少 12 个月随访的原发性开角型青光眼、正常眼压性青光眼或剥脱性青光眼患者 65 只眼（65 例）的数据。比较了两组之间和组内的眼压和青光眼药物数量在 0、1、3、6、9 和 12 个月时的差异。使用重复测量混合模型进行统计分析。我们还使用单变量和多变量逻辑回归分析调查了与治疗成功相关的因素，将治疗后所有随访期间眼压降低≥20%定义为治疗成功。
利匹司特组（n=33）和 SLT 组（n=32）治疗后所有时间点的眼压均显著降低，治疗前后两组之间无统计学差异。治疗前 SLT 组患者使用的抗青光眼药物多于利匹司特组，但随访期间使用的药物少于利匹司特组。无论治疗方式如何，较高的基线眼压与治疗成功相关[未经调整的优势比：1.21（95%置信区间：1.06-1.38），调整后的优势比：1.37（95%置信区间：1.06-1.77）]。
辅助性 SLT 或利匹司特治疗控制不佳的青光眼均可使眼压降至相似程度，但 SLT 有助于减少用药量。
