University of Missouri-Columbia School of Medicine, Columbia, Missouri.
University of Missouri-Columbia School of Medicine, Columbia, Missouri; Department of Ophthalmology, Mason Eye Institute, University of Missouri, Columbia, Missouri; Moyes Eye Center, Kansas City, Missouri.
Ophthalmol Glaucoma. 2022 Nov-Dec;5(6):658-662. doi: 10.1016/j.ogla.2022.06.005. Epub 2022 Jun 14.
To investigate the role of netarsudil as an outcome predictor of MicroPulse transscleral laser therapy (MPTLT).
Retrospective comparative study.
Forty-seven eyes in 33 adult patients with glaucoma with a minimum of 1 month of follow-up after netarsudil treatment and 3 months of follow-up after MPTLT were included. Eyes receiving intraocular pressure (IOP)-lowering procedures in the interim were excluded.
Ophthalmic eyedrops of netarsudil at 0.02%, followed by MPTLT treatment.
Correlation of success between netarsudil and MPTLT. Netarsudil success was defined as an IOP reduction ≥ 20% from baseline, whereas MPTLT success was defined as an IOP reduction ≥ 20% without additional IOP-lowering medications. Secondary outcomes included success rates, mean IOP reduction, adverse effects after each treatment, and netarsudil discontinuation rate.
We found a positive correlation between the netarsudil response and the subsequent MPTLT response (odds ratio, 3.73; 95% confidence interval, 1.05-13.24; P = 0.041). Among netarsudil responders, 73.7% (14/19) of eyes subsequently responded to MPTLT, whereas among netarsudil nonresponders, 42.8% (12/28) of eyes subsequently responded to MPTLT (P = 0.037). From netarsudil, 44.4% of eyes were successful; from MPTLT, 55.3% of eyes were successful. The mean IOP reductions were 2.83 ± 5.74 mmHg from netarsudil and 3.15 ± 6.43 mmHg from MPTLT. Overall, the rate of netarsudil discontinuation was 55.3%. The most common reasons for netarsudil discontinuation were adverse effects (48.9%), followed by high cost (19.1%). The most common adverse effects to netarsudil were conjunctival hyperemia (48.9%) and blurred vision (8.5%). There were no adverse events reported after MPTLT. After MPTLT, 29.8% of eyes required additional IOP-lowering procedures.
The netarsudil response may serve as a predictive marker of the MPTLT response, with over 70% of netarsudil responders subsequently responding favorably to MPTLT in this study.
研究奈拉舒地尔在微脉冲经巩膜激光治疗（MPTLT）中的作用，作为其治疗效果的预测因子。
回顾性对比研究。
纳入了 33 名成年青光眼患者的 47 只眼，这些患者在接受奈拉舒地尔治疗后至少随访 1 个月，在接受 MPTLT 后随访 3 个月。期间接受降眼压手术的眼被排除在外。
奈拉舒地尔滴眼液 0.02%，随后进行 MPTLT 治疗。
奈拉舒地尔与 MPTLT 之间治疗成功的相关性。奈拉舒地尔治疗成功定义为眼压从基线水平降低≥20%，而 MPTLT 治疗成功定义为眼压降低≥20%，且无需额外使用降眼压药物。次要观察指标包括治疗成功率、平均眼压降低、每次治疗后的不良反应以及奈拉舒地尔停药率。
我们发现奈拉舒地尔的反应与随后的 MPTLT 反应之间存在正相关（优势比，3.73；95%置信区间，1.05-13.24；P=0.041）。在奈拉舒地尔治疗有效的患者中，73.7%（14/19）的眼随后对 MPTLT 有反应，而在奈拉舒地尔治疗无效的患者中，42.8%（12/28）的眼随后对 MPTLT 有反应（P=0.037）。从奈拉舒地尔治疗中，44.4%的眼成功，从 MPTLT 治疗中，55.3%的眼成功。奈拉舒地尔的平均眼压降低为 2.83±5.74mmHg，MPTLT 的平均眼压降低为 3.15±6.43mmHg。总的来说，奈拉舒地尔的停药率为 55.3%。奈拉舒地尔停药的最常见原因是不良反应（48.9%），其次是费用高（19.1%）。奈拉舒地尔最常见的不良反应是结膜充血（48.9%）和视力模糊（8.5%）。MPTLT 后没有报告不良反应。MPTLT 后，29.8%的眼需要额外的降眼压治疗。
奈拉舒地尔的反应可能是 MPTLT 反应的预测标志物，在这项研究中，超过 70%的奈拉舒地尔治疗有效患者随后对 MPTLT 反应良好。
