Reffatto Valentina, Gupta Praveena K, Williams Tamila, Schmitz-Brown Mary E, Vizzeri Gianmarco
Ophthalmology, University of Texas Medical Branch, Galveston, USA.
Cureus. 2021 Sep 22;13(9):e18192. doi: 10.7759/cureus.18192. eCollection 2021 Sep.
Purpose This is a retrospective study of primary open-angle glaucoma patients treated with the immunosuppressor FK506 (tacrolimus) after an organ transplant. We assessed whether FK506 might be a potential neuroprotector adjuvant in glaucoma therapy Patients and methods Organ transplant patients treated with FK506 for one or more years between 2006 and 2017 at the University of Texas Medical Branch (UTMB) were enrolled. Those selected were patients older than or equal to 50 years of age and had an ophthalmological eye examination with or without diagnostic tests for primary open-angle glaucoma (POAG). Sixty-one eligible subjects were included in the study and matched with the non-FK506 control group for age, gender, race, and follow-up visits. Results A lower incidence of POAG was noted in the FK506-treated patients (15%) when compared to the non-FK506 group (22%), though not significant (p=0.34). Among POAG subjects, the average retinal nerve fiber layer (RNFL) thickness decreased at a rate of 1.4 µm per year (p=0.0001) in the non-FK506 control patients versus 0.4 µm per year (p=0.34) in the FK506 patients. The superior and inferior RNFL quadrants in the control non-FK506 group had a thinning of 2.2 µm and 2.3 µm per year, respectively, (p=0.003 and p=0.0001), while in the FK506 patients, there was no significant loss. In addition, RNFL thinning in nasal and temporal quadrant also showed less reduction in FK506-treated subjects but was not statistically significant (p=0.68 and p=0.93). Conclusion FK506 therapy offers a new promising avenue for neuroprotection in POAG patients and needs to be investigated further for use in conjunction with conventional glaucoma treatments.
目的 这是一项对器官移植后接受免疫抑制剂FK506（他克莫司）治疗的原发性开角型青光眼患者的回顾性研究。我们评估了FK506是否可能成为青光眼治疗中一种潜在的神经保护佐剂。患者与方法 纳入2006年至2017年期间在德克萨斯大学医学分校（UTMB）接受FK506治疗一年或更长时间的器官移植患者。入选者为年龄大于或等于50岁且接受过眼科检查（无论是否进行原发性开角型青光眼（POAG）诊断测试）的患者。61名符合条件的受试者被纳入研究，并在年龄、性别、种族和随访次数方面与非FK506对照组进行匹配。结果 与非FK506组（22%）相比，FK506治疗组患者的POAG发病率较低（15%），但差异无统计学意义（p = 0.34）。在POAG受试者中，非FK506对照组患者的平均视网膜神经纤维层（RNFL）厚度每年以1.4 µm的速度下降（p = 0.0001），而FK506治疗组患者为每年0.4 µm（p = 0.34）。非FK506对照组的上方和下方RNFL象限每年分别变薄2.2 µm和2.3 µm（p = 0.003和p = 0.0001），而FK506治疗组患者没有明显变薄。此外，FK506治疗组受试者鼻侧和颞侧象限的RNFL变薄程度也较小，但差异无统计学意义（p = 0.68和p = 0.93）。结论 FK506治疗为POAG患者的神经保护提供了一条新的有前景的途径，需要进一步研究其与传统青光眼治疗联合使用的情况。
