Lestak Jan, Fus Martin, Pitrova Sarka
CTU in Prague, Faculty of Biomedical Engineering, 272 01 Kladno 2, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024 Mar 21. doi: 10.5507/bp.2024.010.
In a previous follow-up of glaucoma patients taking carteolol or latanoprost, we found a greater progression of visual field changes with the prostaglandin than the betablocker. In the present study we compared the impact of carteolol and latanoprost on peripapillary vessel density in newly diagnosed primary open-angle glaucoma (POAG) patients.
The study consisted of two groups of POAG patients. There were 46 patient eyes treated with carteolol (Carteol LP 2%) in the first group and 52 eyes treated with latanoprost (Xalatan 0.005%) in the second. Intraocular pressure (IOP), vessel density (VD) and visual field were assessed in all patients. VD was measured peripapillary by optical coherence tomography angiography (OCTA) with the Avanti RTVue XR in eight segments: Inferior Temporal - IT (1); Temporal Inferior -TI (2); Temporal Superior - TS (3); Superior Temporal - ST (4); Superior Nasal - SN (5); Nasal Superior - NS (6); Nasal Inferior - NI (7) and Inferior Nasal - IN (8). The measurements were compared before and after three months of treatment. The visual field was examined with a fast threshold glaucoma program using a Medmont M 700 instrument from Medmont International Pty Ltd. and only when a diagnosis of POAG was done. The overall defect (OD) was assessed.
Before treatment, there was no difference between groups in either OD or VD. After treatment, there was a decrease in IOP in both groups. In the carteolol-treated group, the mean decrease was 5.8 mmHg and in the latanoprost-treated eyes, the mean decrease was 7 mmHg. The difference was not statistically significant (P=0.133). After treatment with carteolol, there was a statistically significant increase in VD in segments 4, 5 and 6. After latanoprost treatment, VD was statistically significantly improved only in segment 5. A greater increase in VD values was found in eyes treated with carteolol than in eyes treated with latanoprost.
Carteolol had a better effect on vessel density than latanoprost.
在之前对服用卡替洛尔或拉坦前列素的青光眼患者的随访中,我们发现使用前列腺素类药物比β受体阻滞剂导致的视野变化进展更大。在本研究中,我们比较了卡替洛尔和拉坦前列素对新诊断的原发性开角型青光眼(POAG)患者视乳头周围血管密度的影响。
该研究由两组POAG患者组成。第一组有46只患眼接受卡替洛尔(卡替洛尔2%滴眼液)治疗,第二组有52只患眼接受拉坦前列素(适利达0.005%)治疗。对所有患者评估眼压(IOP)、血管密度(VD)和视野。通过光学相干断层扫描血管造影(OCTA)使用Avanti RTVue XR在视乳头周围八个象限测量VD:颞下 - IT(1);颞下 - TI(2);颞上 - TS(3);颞上 - ST(4);鼻上 - SN(5);鼻上 - NS(6);鼻下 - NI(7)和鼻下 - IN(8)。在治疗三个月前后比较测量值。使用来自Medmont International Pty Ltd.的Medmont M 700仪器通过快速阈值青光眼程序检查视野,且仅在确诊为POAG时进行。评估总体缺损(OD)。
治疗前,两组在OD或VD方面均无差异。治疗后,两组眼压均降低。在卡替洛尔治疗组,平均降低5.8 mmHg,在拉坦前列素治疗组,平均降低7 mmHg。差异无统计学意义(P = 0.133)。用卡替洛尔治疗后,4、5和6象限的VD有统计学显著增加。用拉坦前列素治疗后,仅5象限的VD有统计学显著改善。发现卡替洛尔治疗的患眼中VD值的增加大于拉坦前列素治疗的患眼。
卡替洛尔对血管密度的影响比拉坦前列素更好。