Konstas A G, Mantziris D A, Cate E A, Stewart W C
University Department of Ophthalmology, AHEPA Hospital, Thessaloniki Greece.
Arch Ophthalmol. 1997 Aug;115(8):975-9. doi: 10.1001/archopht.1997.01100160145002.
To describe and compare the diurnal intraocular pressure (IOP) variation in patients with exfoliation glaucoma (EXG) and primary open-angle glaucoma (POAG) who were treated with a solution of timolol maleate (0.5%) twice daily.
Consecutive Greek patients who were newly diagnosed as having EXG or POAG were prospectively investigated; they underwent 24-hour diurnal IOP measurements first without therapy and then 6 months afterward while they were being treated with timolol maleate (0.5%). After matching for age, 38 pairs of patients with these 2 types of glaucoma were compared.
Untreated patients with EXG had significantly higher IOP values for all time points assessed and a greater mean range of IOPs (11.8 mm Hg for EXG vs 7.6 mm Hg for POAG; P < or = .001). Following therapy with timolol maleate (0.5%) given twice daily, patients with EXG had higher IOP values for the measurements that were obtained at 6 and 10 AM, 10 PM, and 2 AM, a higher mean range of IOPs (7.0 mm Hg for EXG vs 5.6 mm Hg for POAG; P = .03), and a higher maximum IOP (mean, 24.9 mm Hg for EXG vs 20.9 mm Hg for POAG; P = .003). The reduction of the range of diurnal variation of IOP was more pronounced in patients with EXG than in patients with POAG (40% vs 26%; P = .04). Twenty-two (58%) of 38 patients with EXG and 20 (53%) of 38 patients with POAG had peak IOP values that were found outside office hours. Only 5 (13%) of the patients with EXG exhibited an IOP of 18 mm Hg or less at all time points compared with 12 (32%) of the patients with POAG (P = .05).
Despite a greater initial IOP reduction in the patients with EXG treated with timolol, a higher IOP and significant fluctuation in the diurnal curve of IOP during the time in which patients received therapy still characterized EXG from POAG.
描述并比较接受马来酸噻吗洛尔（0.5%）溶液每日两次治疗的剥脱性青光眼（EXG）患者和原发性开角型青光眼（POAG）患者的日间眼压（IOP）变化。
对新诊断为EXG或POAG的希腊患者进行前瞻性连续研究；他们首先在未治疗的情况下进行24小时日间眼压测量，然后在接受马来酸噻吗洛尔（0.5%）治疗6个月后再次测量。在年龄匹配后，对38对这两种类型青光眼的患者进行比较。
在所有评估的时间点，未治疗的EXG患者眼压值显著更高，眼压平均波动范围更大（EXG为11.8 mmHg，POAG为7.6 mmHg；P≤0.001）。在接受每日两次马来酸噻吗洛尔（0.5%）治疗后，EXG患者在上午6点、10点、晚上10点和凌晨2点测量时眼压值更高，眼压平均波动范围更大（EXG为7.0 mmHg，POAG为5.6 mmHg；P = 0.03），最高眼压也更高（平均，EXG为24.9 mmHg，POAG为20.9 mmHg；P = 0.003）。EXG患者眼压日间变化范围的降低比POAG患者更明显（40%对26%；P = 0.04）。38例EXG患者中有22例（58%）和38例POAG患者中有20例（53%）的眼压峰值出现在办公时间以外。与POAG患者中的12例（32%）相比，EXG患者中只有5例（13%）在所有时间点眼压均≤18 mmHg（P = 0.05）。
尽管接受噻吗洛尔治疗的EXG患者初始眼压降低幅度更大，但在接受治疗期间，EXG患者的眼压仍较高，且眼压日间曲线存在显著波动，这仍是EXG与POAG的区别所在。
