局部碳酸酐酶抑制可增加高眼压原发性开角型青光眼的眼动脉压振幅。
Topical carbonic anhydrase inhibition increases ocular pulse amplitude in high tension primary open angle glaucoma.
作者信息
Schmidt K G, von Rückmann A, Pillunat L E
机构信息
Department of Ophthalmology, Justus Liebig University, Giessen, Germany.
出版信息
Br J Ophthalmol. 1998 Jul;82(7):758-62. doi: 10.1136/bjo.82.7.758.
BACKGROUND
Ocular pulse amplitude (OPA) is reduced in normal tension primary open angle glaucoma (NTP) patients when compared with healthy age matched controls (CTL) while increased OPA appears to protect ocular hypertensive patients from visual field loss. If NTP is accompanied by vasospasm, as in roughly half of the primary open angle glaucoma (POAG) population (independent of intraocular pressure, IOP), calcium channel blockers increase OPA and thus stabilise visual fields in these patients. Current glaucoma drugs reduce IOP but do not activate (compromised) ocular perfusion.
METHODS
The influence of dorzolamide, a topical carbonic anhydrase inhibitor in standard dosage (three times daily, one eye) on OPA, IOP, blood pressure, and heart rate was investigated in a randomised, prospective, masked clinical trial assessing the acute effects of dorzolamide v placebo before and 2 days after application in 33 cataract patients with (n = 14) and without (n = 19) high tension POAG (HTP) who provided informed consent.
RESULTS
Following application of dorzolamide (D) IOP (mm Hg, mean (SEM)) in HTPD (20.2 (0.5)/16.3 (0.5) and in CTLD (16.0 (0.5)/12.3 (0.5)) was highly significantly (p < 0.001) reduced and was significantly (p < 0.03) reduced in vehicle (V) treated eyes (HTPv: 20.3 (0.4)/19.0 (0.4)) and CTLv: 15.8 (0.4)/14.9 (0.3)) when compared with respective baseline measurements. OPA (mm Hg) in HTPD (2.1 (0.1)/2.5 (0.1)) and CTLD (2.2 (0.1)/2.6 (0.2)) eyes was significantly (p < 0.05) increased and unaffected in vehicle treated eyes when compared with respective baseline measurements. Systemic perfusion variables were also unchanged.
CONCLUSION
Dorzolamide increased OPA in HTP and CTL. Drugs stimulating OPA may improve prognosis of POAGs.
背景
与年龄匹配的健康对照者（CTL）相比，正常眼压性原发性开角型青光眼（NTP）患者的眼脉冲幅度（OPA）降低，而OPA升高似乎可保护高眼压患者免于视野缺损。如果NTP伴有血管痉挛，就像大约一半的原发性开角型青光眼（POAG）患者群体那样（与眼压（IOP）无关），钙通道阻滞剂可增加OPA，从而稳定这些患者的视野。目前的青光眼药物可降低眼压，但不会激活（受损的）眼部灌注。
方法
在一项随机、前瞻性、双盲临床试验中，研究了标准剂量（每日三次，单眼）的局部碳酸酐酶抑制剂多佐胺对OPA、眼压、血压和心率的影响。该试验评估了多佐胺与安慰剂在33例有（n = 14）和无（n = 19）高眼压性POAG（HTP）的白内障患者中应用前及应用后2天的急性效应，这些患者均提供了知情同意书。
结果
应用多佐胺（D）后，HTPD组（20.2(0.5)/16.3(0.5)）和CTLD组（16.0(0.5)/12.3(0.5)）的眼压（mmHg，均值（标准误））显著降低（p < 0.001），与各自的基线测量值相比，在使用赋形剂（V）治疗的眼睛中（HTPv：20.3(0.4)/19.0(0.4)）和CTLv：15.8(0.4)/14.9(0.3)）眼压也显著降低（p < 0.03）。与各自的基线测量值相比，HTPD组（2.1(0.1)/2.5(0.1)）和CTLD组（2.2(0.1)/2.6(0.2)）眼睛的OPA（mmHg）显著升高（p < 0.05），而在使用赋形剂治疗的眼睛中未受影响。全身灌注变量也未改变。
结论
多佐胺可增加HTP和CTL患者的OPA。刺激OPA的药物可能会改善POAG的预后。
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