Vainio-Jylhä E, Vuori M L
Department of Ophthalmology, Turku University Hospital, Finland.
Graefes Arch Clin Exp Ophthalmol. 1999 Feb;237(2):100-4. doi: 10.1007/s004170050202.
It has been suggested that beta-adrenergic antagonists might have mechanisms of action other than ocular hypotensive effects affecting the visual function in glaucoma patients and that betaxolol might protect the visual field better than others. A randomized, double-blind study was conducted to compare the effects of betaxolol and timolol on visual fields of glaucoma patients.
Sixty-four glaucoma patients were treated with either 0.5% betaxolol or 0.25% timolol eyedrops twice daily. The Octopus visual field performance was followed up for 2 years and analyzed to find diffuse and localized changes. We analyzed the change in the mean sensitivity (MS) and performed a cluster analysis and clinical assessment of the visual fields in both treatment groups.
The mean sensitivity (MS) improved significantly and equally in both treatment groups. There was a tendency towards more improved clusters in the betaxolol group than in the timolol group and more worsened cluster in the timolol group than in the betaxolol group, but the difference was not statistically significant. The clinical assessment also showed no statistically significant difference between the two groups.
In the present study both betaxolol and timolol had a favorable effect on the visual fields of glaucoma patients. There was no statistically significant difference between betaxolol- and timolol-treated patients either in the change in mean retinal sensitivity or in the change in localized scotomatous areas.
有研究表明,β-肾上腺素能拮抗剂可能具有除降低眼压以外的作用机制,影响青光眼患者的视觉功能,且倍他洛尔可能比其他药物能更好地保护视野。本研究进行了一项随机双盲试验,比较倍他洛尔和噻吗洛尔对青光眼患者视野的影响。
64例青光眼患者,分别使用0.5%倍他洛尔或0.25%噻吗洛尔滴眼液,每日2次。随访2年,采用Octopus视野计检查,分析视野的弥漫性和局限性变化。分析两组治疗前后平均敏感度(MS)的变化,并对视野进行聚类分析和临床评估。
两组治疗后平均敏感度(MS)均显著提高,且提高程度相当。倍他洛尔组视野改善聚类趋势多于噻吗洛尔组,噻吗洛尔组视野恶化聚类趋势多于倍他洛尔组,但差异无统计学意义。临床评估也显示两组间无统计学显著差异。
本研究中,倍他洛尔和噻吗洛尔对青光眼患者视野均有良好影响。倍他洛尔组和噻吗洛尔组患者在平均视网膜敏感度变化或局限性暗点区域变化方面均无统计学显著差异。