佛司可林及其类似物抗青光眼研究进展

佛司可林（Ｆｏｒｓｋｏｌｉｎ,ＦＳＫ）及其类似物是腺苷酸环化酶的直接激动剂,具有降低眼压等药理作用。多数学者认为 ＦＳＫ通过减少房水分泌或增加房水的流出来降低眼压。与其它抗青光眼药物相比, ＦＳＫ具有独特的优点,也具有溶解度低,渗透率低,导致生物利用度低的不利之处。国内外目前已将其作为一类新型的抗青光眼药物来研究。综述了佛司可林及其类似物眼用制剂抗青光眼药理基础、临床应用和制剂学方面的研究进展。     

异佛司可林滴眼对清醒兔的降眼压作用

研究异佛司可林悬液滴眼对清醒兔眼内压的作用。方法以气动式非接触眼压计测ＩＯＰ，并记录药物的表面刺激反应。结果０．２５％和１％ｉｓｏＦ分别降压正常ＩＯＰ达０．３７和０．４３ｋＰａ。     

佛司可林类似物激动腺苷酸环化酶及抑制免高眼压探讨

目的：从滇产毛喉鞘蕊花植物中提取到3个佛司可林类似物,即异佛司可林、去酰基佛司可林、1－乙酰基佛司可林,体外测定它们激动腺苷酸环化酶活性,并观察去酰基佛司可林及1－乙酰基佛司可林对水负荷兔高眼压的影响。方法：体外测定激动腺苷酸环化酶活性用蛋白质结合放免法、气动式眼压计察兔眼压。结果：异佛司可林体外激动腺苷酸环化酶活性与佛司可林相当,去酰基佛司林林稍弱,1－乙酰基佛司可林无活性。1％去酰基佛司可林及1－乙酰基佛司可林滴眼液滴兔眼,能抑制水负荷造成的兔高眼压,抑制率最高分别达6.0％及10.9％,作用持续至少3h。结论：研究表明异佛司可林及去酰基佛司可林具有体外激动腺苷酸环化酶活性的作用,而去酰基佛司可林及1－乙酰基佛司可林具有抑制水负荷兔高眼压的作用。     

佛司可林两个类似物对饮水导致的人眼压升高的影响

目的实验观察佛司可林两个类似物,即isoforskolin(isoF),deacetylforskolin(deaF),对饮水导致急性人眼压升高的影响.方法按随机双盲法设计,将佛司可林两个类似物配成的滴眼液分别滴人l眼,相应的溶媒滴入另眼.让受试者饮水(14 ml/kg)造成急性人眼压升高.给药前后用气动式眼压计测定眼压值,观察眼压变化.结果表明isoF(0.5%)及deaF(1.0%)均有抑制作用,最大抑制率分别为¨.4%及12.0%,并且副作用小.结论实验证明isoF(0.5%)及deaF(1.0%)抑制饮水导致急性人眼压升高.     

局部应用酮色林对眼压的影响

局部应用酮色林对眼压的影响［英］／Ｃｏ－ｓｔａｑｌｉｏｌａＣ…∥ＢｒＪＯｐｈｔｈａｌｍｏｌ．－１９９３，７７（６）．－３４４～３４８本临床试验目的是证实局部应用酮色林（ｋｅｔａｎｓｅｒｉｎ）能否降低正常眼和青光眼的眼压。试验组是１０例青光眼患者，男女...     

角膜中央厚度与高眼压症

目的：探讨部分高眼压症患者所表现出的非病理性高眼压（ＯＨＴ）是否为角膜中央厚度（ＣＣＴ）增加所导致的测量误差。方法：共收集了１１名ＯＨＴ患者（２１只眼）及１１名正常对照。用超声角膜测厚仪测量中央角膜厚度,用角膜曲率测量仪测角膜曲率。结果：ＯＨＴ患者ＣＣＴ为５９４．８±１７．５μｍ,明显高于正常对照（５２９．１±２７．３μｍ）,两组角膜曲率差异无显著性。结论：至少一部分ＯＨＴ患者所表现出的非病理性高眼压来源于增厚的角膜中央厚度造成的测量误差。测量ＣＣＴ对于正确评估压平眼压,判断患者是否存在视野损害的危险及确定治疗与否的临界眼压具有重要临床意义。     

治疗小果切除术联合应用MMC后导致低眼压性黄斑病变

治疗小果切除术联合应用ＭＭＣ后导致低眼压性黄斑病变［英］／ＮｕｙｔｓＲＭＭＡ…∥ＡｍＪＯｐｈｔｈａｌｍｏｌ．－１９ｇ４，１１８（３）。－３２２～３３１小梁切除术联合应用抗代谢药物引起术后低眼压性黄斑病变是由于应用ＭＭＣ（丝裂霉素ｃ）和５，ＦＵ（５－氟...     

LASIK对非接触型眼压计测量眼压的影响

目的：分析准分子激光原位角膜磨镶术（ｌａｓｅｒ ｉｎ ｓｉｔｕ ｋｅｒａｔｏｍｉｌｅｕｓｉｓ,ＬＡＳＩＫ）治疗近视眼术后眼压的影响因素。方法：采用ＬＡＳＩＫ治疗２１４只近视眼。用非接触式眼压计测量术前、术后的眼压。对眼压与术前、术后各因素进行相关分析和多元逐步回归分析。结果：ＬＡＳＩＫ术后１月的眼压明显低于术前,差异具有显著性意义（ｓｔｕｄｅｎｔ ｔ检验,Ｐ〈０．０００１）。ＬＳＡＩＫ术后眼压的降     

非瑟酮对人晶状体上皮细胞增殖和凋亡的影响

目的　研究非瑟酮（ｆｉｓｅｔｉｎ,Ｆｉｓ）在生理状态下及氧化应激状态下对人晶状体上皮细胞（ｈｕｍａｎｌｅｎｓｅｐｉｔｈｅｌｉａｌｃｅｌｌ,ＨＬＥＣ）增殖和凋亡的影响。方法　体外培养ＨＬＥＣ,通过Ｈ２Ｏ２氧化损伤建立氧化应激模型,设置空白对照组、Ｈ２Ｏ２组、Ｆｉｓ组和Ｆｉｓ＋Ｈ２Ｏ２组,其中Ｆｉｓ组和Ｆｉｓ＋Ｈ２Ｏ２组按Ｆｉｓ浓度（５μｇ?ｍＬ－１、１０μｇ?ｍＬ－１和２０μｇ?ｍＬ－１）分为３个亚组。分别于培养１２ｈ及２４ｈ后,倒置相差显微镜下观察各组细胞的形态学改变,运用ＭＴＴ法检测细胞增殖的变化,运用流式细胞技术检测细胞凋亡率的变化。结果　与空白对照组比较,Ｈ２Ｏ２组较多细胞出现典型的形态学改变,细胞增殖能力明显降低（１２ｈ、２４ｈ后分别为０．１１７６±０．０１５０和０．１１７２±０．００６１）,凋亡率明显增加（２４ｈ后为１２．３５％ ±１．２３％）,差异均有统计学意义（均为Ｐ＜０．０１）。不同浓度Ｆｉｓ组间的细胞在培养１２ｈ及２４ｈ后细胞形态均无明显改变,细胞增殖也无明显变化（Ｐ＞００５）。培养１２及２４ｈ后,与Ｈ２Ｏ２组比较,Ｆｉｓ＋Ｈ２Ｏ２组发生形态改变的细胞减少,细胞增殖能力明显改善,且随时间、Ｆｉｓ浓度增加其作用更明显（最高为０．３９９４±０．０２５７）（Ｐ＜０．０５）。培养２４ｈ后,与Ｈ２Ｏ２组凋亡率比较,不同浓度Ｆｉｓ＋Ｈ２Ｏ２组的细胞凋亡率逐渐降低,依次为（９．９９±１．５３）％、（５．８０±１．５５）％、（３．５８±０．７３）％,差异有统计学意义（Ｐ＜０．０５）。结论　一定浓度的Ｆｉｓ在一定时段对生理状态下的ＨＬＥＣ增殖无明显影响。在氧化应激状态下,Ｆｉｓ呈时间和浓度依赖性地改善ＨＬＥＣ增殖能力,呈浓度依赖性地降低ＨＬＥＣ凋亡率。     

前列腺素对眼压及青光眼影响的研究进展

前列腺素对眼压及青光眼影响的研究进展潍坊医学院孙兴才综述尤毓陆审校前列腺素（Ｐｒｏｓｔａｇｌａｎｄｉｎｓｐｏ）是一类具有很强主物活性的脂质，国内外研究颇多。但早期研究仅局限于眼内刺激性炎症反应方面．直到七十年代，发现局部小剂量应用具有良好的降眼压作用...     

Effects of central corneal thickness on the efficacy of topical ocular hypotensive medications

PURPOSE: To determine the effect of central corneal thickness (CCT) on the efficacy of intraocular pressure (IOP)-reducing drugs in patients with ocular hypertension (OHT). METHODS: This retrospective study analyzed research records of 115 OHT patients and 97 ocular normotensive (ONT) volunteers. CCT was measured by slit-lamp pachymetry and IOP by pneumatonometry. The OHT patients were divided into Thick (>540 microm, n=52) and Thin (相似文献   

兔实验性急性高眼压模型视网膜谷氨酸的变化

目的 研究兔实验性急性高眼压状态下视网膜谷氨酸含量的变化。探讨谷氨酸在青光眼高神经损害中的作用。方法 应用邻苯二甲醛衍生法、高效液相色谱仪测定视网膜谷氨酸的含量,将１８只大白兔分成３组,其中２个组１个正常对照组,每组均６只兔（６只眼）。实验１组：每只兔随机选取１只眼行生理盐水前房内高压灌注,６０ｍｍＨｇ（１ｍｍＨｇ＝０．１３３ｋＰａ）持续４ｈ。另１只眼生理盐水前房内灌注,方法同前,量压力为２０ｍｍ     

Additive effect of unoprostone and latanoprost in patients with elevated intraocular pressure.

AIMS: To assess the additive effect of unoprostone and latanoprost in patients with primary open angle glaucoma (POAG) or ocular hypertension (OHT) METHODS: 32 patients with POAG or OHT were randomised to receive either latanoprost once daily or unoprostone twice daily for 4 weeks. After 4 weeks, all patients received both latanoprost and unoprostone for another 4 weeks. The IOP was measured at 9 am and 5 pm on the baseline, day 28, and day 56 visits, and at 9 am on day 14 and day 42 visits. The medications were given to the patients in an open label fashion. The observer was masked to the treatment given. The mean of the measurements was calculated. Safety parameters were also recorded. The additive effect of the medications was assessed by the reduction in intraocular pressure (IOP) when both medications were used, compared with when one medication was used. RESULTS: 28 patients completed both treatment periods and had IOP data available for evaluation. After 1 month of treatment, latanoprost significantly reduced IOP (mean by 6.1 (SEM 0.8) mm Hg (p<0.001) and unoprostone by 4.9 (1.0) mm Hg (p<0.001) from the baseline of 24.4 (0.6) mm Hg and 24.4 (1.1) mm Hg respectively (p = 0.18). When latanoprost once daily was given to patients treated with unoprostone, there was additional IOP lowering of 1.9 (0.6) mm Hg (p = 0.012). However, adding unoprostone to those being treated with latanoprost produced an IOP change of +0.4 (0.5) mm Hg (p = 0.42). Ocular symptoms and findings were mild and equally distributed between treatment groups, and after combined therapy. Hyperaemia and ocular irritation were the most frequently reported events. Over a third of patients experienced ocular irritation with the combination of medications. CONCLUSIONS: Latanoprost once daily causes additional IOP lowering in eyes which were being treated with unoprostone twice a day. However, there was no additional IOP lowering when unoprostone was added to eyes which were being treated with latanoprost. Both drugs were well tolerated together with few ocular adverse events.     

Post-steroid elevations of intraocular pressure in patient after radial keratotomy

PURPOSE: The evaluation of frequency and amplitude of IOP elevations in patients after RK who were administrated topically dexamethasone. MATERIAL AND METHODS: RK was carried out in 90 eyes (55 patients). All these patients had been treated topically with 0.1% dexamethasone (Maxitrol, Alcon) since the first day after surgery till the period of 3 months in lowering doses. IOP was measured using air-puff tonometer (Reichert, USA) before surgery and on 1, 2, 3, 14, 30, 50, 90 day after RK. In case of IOP elevations the measurements were made more often. RESULTS: The mean IOP before surgery was 14.88 +/- 2.86 mm Hg for women and 16.14 +/- 2.83 mm Hg for men. In the period of 3 months after RK maximum IOP increased significantly both for women (mean: 21.46 +/- 7.51 mm Hg) and men (mean: 26.14 +/- 8.87 mm Hg). IOP higher than 25 mm Hg was observed in 35 eyes (37.7%). These IOP elevations were observed more often in men than women but this difference was not statistically significant. There was no correlation between frequency of IOP elevations and preoperative refractive error or the age of patients. CONCLUSIONS: The usage of steroids after RK requires careful monitoring of IOP. This subject needs further studies to answer if these IOP elevations can damage eye functions.     

Novel pressure-to-cornea index in glaucoma

BACKGROUND: Several conversion tables and formulas have been suggested to correct applanation intraocular pressure (IOP) for central corneal thickness (CCT). CCT is also thought to represent an independent glaucoma risk factor. In an attempt to integrate IOP and CCT into a unified risk factor and avoid uncertain correction for tonometric inaccuracy, a new pressure-to-cornea index (PCI) is proposed. METHODS: PCI (IOP/CCT(3)) was defined as the ratio between untreated IOP and CCT(3) in mm (ultrasound pachymetry). PCI distribution in 220 normal controls, 53 patients with normal-tension glaucoma (NTG), 76 with ocular hypertension (OHT), and 89 with primary open-angle glaucoma (POAG) was investigated. PCI's ability to discriminate between glaucoma (NTG+POAG) and non-glaucoma (controls+OHT) was compared with that of three published formulae for correcting IOP for CCT. Receiver operating characteristic (ROC) curves were built. RESULTS: Mean PCI values were: Controls 92.0 (SD 24.8), NTG 129.1 (SD 25.8), OHT 134.0 (SD 26.5), POAG 173.6 (SD 40.9). To minimise IOP bias, eyes within the same 2 mm Hg range between 16 and 29 mm Hg (16-17, 18-19, etc) were separately compared: control and NTG eyes as well as OHT and POAG eyes differed significantly. PCI demonstrated a larger area under the ROC curve (AUC) and significantly higher sensitivity at fixed 80% and 90% specificities compared with each of the correction formulas; optimum PCI cut-off value 133.8. CONCLUSIONS: A PCI range of 120-140 is proposed as the upper limit of "normality", 120 being the cut-off value for eyes with untreated pressures or=22 mm Hg. PCI may reflect individual susceptibility to a given IOP level, and thus represent a glaucoma risk factor. Longitudinal studies are needed to prove its prognostic value.     

The comparison of topical ibopamine 2% with tonography to identify the outflow resistance in eyes with ocular hypertension

BACKGROUND: To evaluate the ability of topical ibopamine 2% to detect outflow resistance by comparing it with the tonography test in eyes with ocular hypertension (OHT). METHODS: 62 eyes with OHT and 33 control eyes were included in this prospective study. Tonography was done manually as a standard outflow facility measurement. We used a C value of 0.18 mul/min/mm Hg or less and a P(o)/C value of 100 and above as a positive tonographic test. The ibopamine test performed on the following day was considered positive if there was an intraocular pressure (IOP) change of at least 3 mm Hg. RESULTS: The sensitivity of the tonography and ibopamine tests was 69 and 53%, respectively, in eyes with OHT. The specificity of both tests was 97%. Although the sensitivity of the tonography test is higher than that of the ibopamine test, the difference between both was not statistically significant in these eyes (p = 0.409). Positive results in tonography were associated with higher IOP, while the results were not dependent on the IOP in the ibopamine test. Both tests together were positive in 33.87% (21 eyes) and negative in 11.29% (7 eyes) in 62 eyes with OHT. CONCLUSION: This study revealed that the ibopamine provocation test can detect outflow system resistance in eyes with OHT comparable with tonography which is a traditional outflow facility measurement. Ibopamine, however, can detect the eye with outflow impairment by a different and IOP-independent way, while tonography depends on IOP.     

Effect of 5-MCA-NAT, a putative melatonin MT3 receptor agonist, on intraocular pressure in glaucomatous monkey eyes

PURPOSE: 5-MCA-NAT, a putative melatonin MT3 receptor agonist, reduced intraocular pressure (IOP) in ocular normotensive rabbit eyes. This study evaluates the effect of topical application of 5-MCA-NAT on IOP in monkey eyes with laser-induced unilateral glaucoma. METHODS: A multiple-dose study was performed in 8 glaucomatous monkey eyes. One 25-microL drop of 5-MCA-NAT (2%) was applied topically to the glaucomatous eye at 9:30 am and 3:30 pm for 5 consecutive days. IOP was measured hourly for 6 hours beginning at 9:30 am for one baseline day, one vehicle-treated day, and treatment days 1, 3, and 5 with 5-MCA-NAT. RESULTS: Compared with vehicle treatment, twice daily administration of 5-MCA-NAT for 5 days reduced (P < 0.05) IOP from 1 hour to 5 hours after the first dose, and the IOP-lowering effects were shown to last at least 18 hours following administration, based on IOP measurements made after the fourth and eighth doses. The ocular hypotensive effect of 5-MCA-NAT was enhanced with repeated dosing. The maximum reduction (P < 0.001) of IOP occurred at 3 hours after each morning dose, and was 4.0 +/- 0.5 (mean +/- SEM) mm Hg (10%) on day 1, 5.6 +/- 0.8 mm Hg (15%) on day 3, and 7.0 +/- 1.1 mm Hg (19%) on day 5. Adverse ocular or systemic side effects were not observed during the 5 days of treatment. CONCLUSIONS: 5-MCA-NAT, a putative melatonin MT3 receptor agonist, reduces IOP in glaucomatous monkey eyes. Melatonin agonists with activity on the putative MT3 receptor may have clinical potential for treating elevated IOP.     

Epidemiologic approach to open-angle glaucoma: 1. Control of intraocular pressure. Report of the Canadian Ocular Adverse Drug Reaction Registry Program

In a multicentre study eight glaucoma consultants prospectively followed 71 unselected cases (130 eyes) of newly diagnosed open-angle glaucoma at five visits over a mean interval of 12.1 months. A standard flow chart was used to record the medical treatment, intraocular pressure (IOP) and indications for any changes in therapy. No limitations were imposed on the choice of drugs. The mean IOP before treatment was 28 mm Hg. There was a significant reduction in mean IOP of 7.64 mm Hg in response to the first drug prescribed (p less than 0.0001) but none thereafter, despite changes in treatment in 25% to 32% of eyes at each visit. The mean standard deviation of IOP for all eyes was 2.62 mm Hg. Of 99 changes in therapy in 67 eyes, 40% were made when the IOP was within 3 mm Hg of the mean satisfactory pressure for a particular case. The findings indicate the need to make corrections for variation and fluctuation in IOP when evaluating pressure response. The pharmacologic effect of the drugs appeared less important than the patient's ability to tolerate the drugs without severe adverse reactions.