Sakurai Katsumasa, Suda Kenji, Akagi Tadamichi, Ikeda Hanako Ohashi, Kameda Takanori, Miyake Masahiro, Hasegawa Tomoko, Tsujikawa Akitaka
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Department of Ophthalmology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
J Ophthalmol. 2025 Jan 15;2025:2962982. doi: 10.1155/joph/2962982. eCollection 2025.
The effect of the Rho-kinase inhibitor ripasudil on the retinal optic nerve fiber layer (RNFL) remains unclear. We aimed to determine this effect in patients with primary open-angle glaucoma (POAG) using optical coherence tomography (OCT) measurements and linear mixed analysis. This study prospectively included outpatients from a single center with POAG without a history of vitreoretinal or glaucoma surgery from December 2014 to June 2020, in whom the circumpapillary RNFL thickness (cpRNFLT) was measured more than three times before and after ripasudil initiation, without additional medication or surgery during the period. Measurements were performed using OCT in the follow-up mode. The cpRNFLT change rates were compared before and after treatment using linear mixed models with adjustments for intraocular pressure (IOP) changes. Thirty eyes of 20 patients (12 males and eight females) were included. Upon ripasudil prescription, the average cpRNFLT was 60.2 ± 2.1 μm. The average IOP was 15.1 ± 0.5 and 13.5 ± 0.5 mmHg, respectively, before and after treatment initiation, with a difference of -1.6 ± 0.3 mmHg. Analysis of 343 cpRNFLT measurements using linear mixed models revealed that the cpRNFLT change rate was -0.91 ± 0.15 and -0.40 ± 0.14 μm/year, respectively, before and after treatment onset, with an increase of 0.51 ± 0.21 μm/year. After adjusting for IOP changes, the improvement in cpRNFLT change rate was 0.33 ± 0.23 μm/year, albeit not statistically significant. The cpRNFLT change rate significantly increased after ripasudil administration, whereas the contribution of the IOP decline was not significant.
Rho激酶抑制剂法舒地尔对视网膜视神经纤维层（RNFL）的影响尚不清楚。我们旨在通过光学相干断层扫描（OCT）测量和线性混合分析来确定其对原发性开角型青光眼（POAG）患者的影响。本研究前瞻性纳入了2014年12月至2020年6月来自单一中心的POAG门诊患者，这些患者无玻璃体视网膜或青光眼手术史，在开始使用法舒地尔之前和之后对其视盘周围RNFL厚度（cpRNFLT）进行了三次以上测量，在此期间未进行额外药物治疗或手术。测量在随访模式下使用OCT进行。使用线性混合模型比较治疗前后的cpRNFLT变化率，并对眼压（IOP）变化进行校正。纳入了20例患者（12例男性和8例女性）的30只眼。在开具法舒地尔处方时，平均cpRNFLT为60.2±2.1μm。治疗开始前和后平均眼压分别为15.1±0.5和13.5±0.5mmHg，差值为-1.6±0.3mmHg。使用线性混合模型对343次cpRNFLT测量进行分析显示，治疗开始前和后cpRNFLT变化率分别为-0.91±0.15和-0.40±0.14μm/年，增加了0.51±0.21μm/年。在对IOP变化进行校正后，cpRNFLT变化率的改善为0.33±0.23μm/年，尽管无统计学意义。法舒地尔给药后cpRNFLT变化率显著增加，而眼压下降的作用不显著。
