Bastelica Paul, Renard Jean Paul, Aptel Florent, Labbé Antoine, Schweitzer Cédric, Poli Muriel, Rousseau Antoine, Lamirel Cédric, Baudouin Christophe
Quinze-Vingts National Ophthalmology Hospital, INSERM-DHOS CIC 1423, IHU FOReSIGHT, 75012, Paris, France.
Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, IHU FOReSIGHT, 28 rue de Charenton, 75012, Paris, France.
Ophthalmol Ther. 2024 Jun;13(6):1537-1551. doi: 10.1007/s40123-024-00936-9. Epub 2024 Apr 8.
Even though the local tolerance of prostaglandin (PG) analogues has improved drastically since the introduction of preservative-free (PF) eye drops, prescription patterns still vary widely among practitioners and between countries and could have an impact on the ocular surface of treated patients and, in consequence, their adherence. The aim of this study is to explore the prescribing patterns of PG analogues monotherapy in France and to evaluate their impact on ocular surface status.
This was a national multicenter cross-sectional observational study that was conducted by 18 glaucoma experts in France. Patients over 18 years of age and receiving monotherapy with topical PG analogues for the treatment of ocular hypertension and/or glaucoma, with no history of prior glaucoma surgery, were consecutively selected from the glaucoma outpatient clinics of participating physicians and underwent an ocular surface examination.
A total of 344 eyes of 344 patients were enrolled between November 2022 and November 2023. Prescribed PG monotherapy was PF in 271 (78.7%) patients. Clinical history and ocular surface evaluation indicated that 79.4% of the study population (n = 273) presented with at least one symptom or clinical sign of dry eye and that three patients out of four had an unstable tear film. Subgroup analysis comparing preserved and PF PG analogues showed a higher prevalence of conjunctival hyperemia and corneal staining in the preserved group. Multivariate analysis identified conjunctival hyperemia as consistently associated with preservative use (odds ratio = 7.654; p = 0.003 for moderate conjunctival hyperemia).
This study highlights the growing trend toward PF PG analogue prescriptions by specialists in France. However, ocular surface issues remain prevalent, impacting patient adherence and treatment efficacy. Comprehensive ocular surface examinations are crucial in glaucoma management to enhance long-term tolerance, compliance, and overall treatment success.
尽管自无防腐剂（PF）滴眼液问世以来，前列腺素（PG）类似物的局部耐受性已大幅改善，但不同从业者之间以及不同国家之间的处方模式仍存在很大差异，这可能会对接受治疗患者的眼表产生影响，进而影响他们的依从性。本研究的目的是探讨法国PG类似物单一疗法的处方模式，并评估其对眼表状况的影响。
这是一项由法国18位青光眼专家进行的全国多中心横断面观察性研究。从参与医生的青光眼门诊连续选取年龄在18岁以上、接受局部PG类似物单一疗法治疗高眼压症和/或青光眼且无青光眼手术史的患者，并进行眼表检查。
2022年11月至2023年11月期间，共纳入344例患者的344只眼。271例（78.7%）患者接受的PG单一疗法为PF滴眼液。临床病史和眼表评估表明，79.4%的研究人群（n = 273）至少出现一种干眼症状或临床体征，四分之三的患者泪膜不稳定。比较含防腐剂和PF PG类似物的亚组分析显示，含防腐剂组结膜充血和角膜染色的患病率更高。多变量分析确定结膜充血与使用防腐剂始终相关（优势比 = 7.654；中度结膜充血p = 0.003）。
本研究凸显了法国专家开具PF PG类似物处方的趋势不断增加。然而，眼表问题仍然普遍存在，影响患者依从性和治疗效果。在青光眼管理中，全面的眼表检查对于提高长期耐受性、依从性和整体治疗成功率至关重要。
