Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2020 Dec;34(6):425-431. doi: 10.3341/kjo.2020.0061. Epub 2020 Dec 3.
To investigate the current management patterns of glaucoma subspecialists with regard to normal-tension glaucoma (NTG) in Korea and to determine the effect of the two largest NTG trials on their clinical practice.
A questionnaire survey was sent to glaucoma subspecialist members of the Korean Glaucoma Society. The questionnaire concerned regular practice with respect to NTG and the extent to which it has been influenced by the Collaborative Normal-tension Glaucoma Study and the Low-pressure Glaucoma Treatment Study (LoGTS).
A total of 134 glaucoma subspecialists completed the survey, with a response rate of 56%. The survey reported that 88% and 78% of glaucoma subspecialists were familiar with the Collaborative Normal-tension Glaucoma Study and the LoGTS, respectively. With respect to mild or moderate NTG, most of the respondents (87%-91%) tended to treat their patients immediately without waiting for structural or functional progression. Among the respondents, 47 indicated that the LoGTS results-according to which, 20% of the respondents tended to use brimonidine more often-affected their management. The first-choice topical drugs for NTG were prostaglandin analogues (76%), brimonidine (9%), beta-blockers (8%), and topical carbonic anhydrase inhibitor (6%).
Regarding mild-to-moderate NTG, Korean glaucoma subspecialists tended to initiate treatment without waiting for further progression. The impact of the LoGTS on NTG management was not dominant in clinical practice in Korea. Prostaglandin analogs are the most frequently selected first-choice drugs for the management of NTG in Korea.
调查韩国青光眼专家在正常眼压性青光眼(NTG)方面的当前管理模式,并确定两项最大的 NTG 试验对其临床实践的影响。
向韩国青光眼学会的青光眼专家成员发送了一份问卷调查。问卷涉及 NTG 的常规治疗以及协作性正常眼压青光眼研究和低眼压青光眼治疗研究(LoGTS)对其的影响程度。
共有 134 名青光眼专家完成了调查,应答率为 56%。调查显示,88%和 78%的青光眼专家分别熟悉协作性正常眼压青光眼研究和 LoGTS。对于轻度或中度 NTG,大多数受访者(87%-91%)倾向于立即治疗患者,而不等待结构或功能进展。在受访者中,有 47 人表示 LoGTS 结果——根据该结果,有 20%的受访者倾向于更频繁地使用溴莫尼定——影响了他们的管理。NTG 的首选局部药物是前列腺素类似物(76%)、溴莫尼定(9%)、β-受体阻滞剂(8%)和局部碳酸酐酶抑制剂(6%)。
对于轻度至中度 NTG,韩国青光眼专家倾向于在不等待进一步进展的情况下开始治疗。LoGTS 对 NTG 管理的影响在韩国的临床实践中并不占主导地位。前列腺素类似物是韩国 NTG 管理中最常选择的一线药物。