Droste Andrew P, Newman-Casey Paula Anne
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA.
Expert Rev Ophthalmol. 2023;18(2):101-111. doi: 10.1080/17469899.2023.2199981. Epub 2023 Apr 12.
Non-adherence to glaucoma medication and poor follow-up is a global health concern.
Glaucoma remains one of the largest causes of irreversible blindness worldwide. Traditional treatment guidelines suggest topical eye drop medication as first line therapy followed by addition of supplementary medications before proceeding to more invasive glaucoma surgeries. Unfortunately, poor glaucoma self-management remains high, leading to disease progression and blindness. Recent advancements in the field of pharmacotherapies, surgeries, and behavioral approaches have taken aim at increasing support for glaucoma self-management. We review the current and emerging approaches towards glaucoma management, with the exception of bleb-based surgical approaches, to investigate if they have had an impact on adherence. Literature searches were conducted via MEDLINE (PubMed), Embase (Elsevier), Cochrane Library (Wiley), and Preprints from January 1, 2018, to January 26th, 2023.
The ability to offer patients a multitude of choices enables patients to tailor their glaucoma treatment to their values and lifestyle. Offering personalized patient education and coaching to support chronic glaucoma self-management would better enable patient engagement in whichever treatment path is chosen. Currently, literature regarding the impact of these new advancements on treatment engagement is lacking; this field is ripe for additional intervention and assessment.
不坚持使用青光眼药物以及随访不佳是一个全球健康问题。
青光眼仍然是全球不可逆性失明的主要原因之一。传统治疗指南建议将局部滴眼剂药物作为一线治疗,然后在进行更具侵入性的青光眼手术之前添加辅助药物。不幸的是,青光眼自我管理不善的情况仍然很普遍,导致疾病进展和失明。药物治疗、手术和行为方法领域的最新进展旨在加强对青光眼自我管理的支持。我们回顾了当前和新兴的青光眼管理方法(基于滤过泡的手术方法除外),以研究它们是否对依从性产生了影响。通过MEDLINE(PubMed)、Embase(爱思唯尔)、Cochrane图书馆(威利)以及2018年1月1日至2023年1月26日的预印本进行文献检索。
为患者提供多种选择的能力使患者能够根据自己的价值观和生活方式调整青光眼治疗方案。提供个性化的患者教育和指导以支持慢性青光眼自我管理,将更好地使患者参与所选择的任何治疗路径。目前,缺乏关于这些新进展对治疗参与度影响的文献;该领域有待进一步干预和评估。