PNT治疗开角型青光眼及高眼压症的临床观察

目的观察应用PNT（真空小梁成形术）来治疗开角型青光眼（POAG）以及高眼压症的临床效果。方法选取我院2012年3月至2012年12月所收治的22例35眼POAG以及高眼压症患者的临床资料，治疗前常规进行眼科检查，如测量视力、视野、眼压、屈光度、中央角膜厚度、眼底、裂隙灯、前房角镜及OCT（视盘相干光断层扫描），之后进行PNT治疗，于手术治疗后1周重复1次治疗，观察在首次治疗后lh、1d、1周、2周、1个月、2个月、3个月的眼压以评价临床效果。结果所有患者在治疗前其眼压平均为（23．2±4．8）mmHg（1mmHg=0．133kPa），除治疗后lh，其他各时间点眼压均明显优于治疗前，具有统计学意义（P〈0．05）。结论采用PNT来治疗POAG及高眼压症患者，可显著降低其眼压，使视力得到一定恢复，是一种安全有效地治疗方案，值得在在临床上推广。     

无创青光眼治疗系统对开角型青光眼及高眼压症眼压的影响

目的:观察无创青光眼治疗系统对开角型青光眼以及高眼压症在不同时间段的降眼压效果.方法:51例开角型青光眼或高眼压症患者(70眼)于首次确诊时、1周各行一次PNT治疗,分别于首次PNT后l天、l周、2周、1月、2月、3月记录眼压(OP)值.结果:所有患者于确诊时、PNT治疗后l天、1周、2周、1月、2月、3月眼压分别较治疗前均有下降且眼压差异均有统计学意义(P＜0.05).结论:无创青光眼治疗系统对开角型青光眼及高眼压症患者有一定的降眼压作用.     

他氟前列素滴眼液联合盐酸卡替洛尔滴眼液治疗开角型青光眼的疗效及安全性评价

目的:研究他氟前列素眼滴液和盐酸卡替洛尔滴眼液联合治疗开角型青光眼的疗效及其安全性。方法:选取2017年8月~2018年8月在某院眼科接受开角型青光眼治疗的患者100例(200眼),将其随机均分为单一组和联合组,每组50例(100眼)。单一组利用盐酸卡替洛尔滴眼液进行单一治疗,联合组在单一组的基础上利用他氟前列素眼滴液进行联合治疗,对比两组患者的治疗效果,并统计其在治疗过程中发生不良反应的情况,对治疗的安全性进行评价。结果:联合组治疗的总有效率显著高于单一组患者(P<0.05);单一组患者不良反应发生率为显著高于联合组(P<0.05)。结论:对于患有开角型青光眼的患者的治疗来说,他氟前列素眼滴液和盐酸卡替洛尔滴眼液联合治疗的方法对比盐酸卡替洛尔滴眼液单一治疗,不仅有着更好的临床疗效,而且有着更低的不良反应发生率,因此值得推广。     

PNT治疗原发性开角型青光眼及高眼压症的临床观察

青光眼在全球是仅次于白内障的导致视力丧失的主要疾病,而且缺乏可靠的预防方法。在临床上通常将青光眼分为原发性、继发性和发育性三大类,原发性青光眼是主要的青光眼类型,又可将原发性青光眼分为闭角型青光眼和开角型青光眼。在我国的原发性青光眼中,开角型少于闭角型,但近年来临床所占比例有所上升,可能与代谢性疾病(如糖尿病)、近视眼等的发病增加,以及卫生保健和诊断水平的提高     

观察倍他洛尔和溴莫尼定联合治疗开角型青光眼和高眼压症的效果

目的:观察溴莫尼定和倍他洛尔联合治疗开角型青光眼和高眼压症的临床效果.方法:将2014年8月~2016年12月,总计50例(94只眼)开角型青光眼和高眼压症患者(其中开角型青光眼患者为23例(42只眼),高眼压症患者为27例(52只眼)),随机分为A、B两组,每组25例,其中A组48只眼,B组46只眼.A组使用溴莫尼定联合倍他洛尔治疗,B组使用倍他洛尔治疗,每天滴药两次,分别观察并且记录给药后1、4、8、12周后的眼压和不良反应.结果:A、B两组在连续治疗3个月后,眼压明显下降,但A组有效率相比B组明显更高,差异存在统计学意义(P<0.05).A、B两组治疗前眼压比较差异无统计学意义(P>0.05);经过1、4、8、12周的治疗组间比较差异较小(P>0.05);与用药前比较,用药1、4、8、12周眼压改善情况较为明显(P<0.05).结论:溴莫尼定联合倍他洛尔对治疗开角型青光眼和高眼压症有良好疗效,且没有严重不适应症状.     

贝美前列素治疗原发性开角型青光眼和高眼压症的最小成本分析

目的：对贝关前列素滴眼液与同类对照药物拉坦前列素滴眼液治疗原发性开角型青光眼和高眼压症进行药物经济学评价。方法：应用最小成本分析,对参加多中心临床试验医院采用回顾性调查收集费用数据并进行测算。结果：从药物费用上比较两药6周费用之差33．52—35．28元,从6个月诊疗总费用上看,贝美前列素滴眼液的诊疗费用439．6-918．3元,拉坦前列素滴眼液的诊疗费680．8～1062．0元,诊疗总费用在四个地区情况均为贝美前列素低于拉坦前列素。结论：贝美前列素滴眼液治疗相比于拉坦前列素治疗是经济的治疗方案,值得推荐应用。     

治疗青光眼新药他氟前列素滴眼液

他氟前列素滴眼液(tafluprost eye drops)是一种新型不含防腐剂的前列腺素类似物滴眼药。最新研究显示,本品与其他含防腐剂的前列腺素类滴眼液一样,能有效降低青光眼患者的高眼压,且安全性高、耐受性好。Tafluprost已于2012年2月获得美国FDA的上市批准,将成为临床上有前景的治疗青光眼药物。本文综述其药理作用、临床研究、安全性等。     

清肝降压胶囊联合他氟前列素滴眼液治疗开角型青光眼的疗效观察

目的 探讨清肝降压胶囊联合他氟前列素滴眼液治疗开角型青光眼的临床疗效.方法 选取2019年1月—2020年8月洛阳市第三人民医院收治的94例开角型青光眼患者作为研究对象,按照随机数字表法将94例患者分为对照组和治疗组,每组各47例.对照组给予他氟前列素滴眼液,1滴/次,1次/d.治疗组在对照组基础上口服清肝降压胶囊,3...     

国产拉坦前列腺素治疗开角型青光眼和高眼压症的疗效研究

目的 分析研究国产拉坦前列腺素治疗开角型青光眼和高眼压症的疗效.方法 将我院于2015年10月至2016年10月收治的开角型青光眼和高眼压症患者90例作为本研究对象,采用数字表格法随机分为对照组和观察组,每组各45例.对照组使用进口拉坦前列腺素治疗,观察组使用国产拉坦前列腺素治疗,比较两组的治疗效果及安全性.结果 两组之间治疗前的眼压比较,以及治疗后的眼压比较差异均没有统计学意义(P>0.05);治疗后两组眼压均有明显下降,其前后比较差异有统计学意义(P<0.05).结论 国产拉坦前列腺素治疗开角型青光眼和高眼压症,能够有效降低眼压,具有与进口拉坦前列腺素相同疗效及安全性.     

曲伏前列素滴眼液治疗原发性开角型青光眼的有效性及安全性分析

目的:分析曲伏前列素滴眼液治疗原发性开角型青光眼的有效性及安全性.方法:原发性开角型青光眼患者46例(82眼),随机分为实验组和对照组,对照组23例(40眼)采用噻吗洛尔滴眼液治疗,实验组23例(42眼)采用曲伏前列素滴眼液治疗,比较两组治疗效果及不良反应情况.结果:治疗前,两组眼压及视力无明显差异(P>0.05);经过治疗,实验组眼压低于对照组,且视力高于对照组(P<0.01);两组在治疗过程中的不良反应发生率无明显差异(P>0.05).结论:曲伏前列素滴眼液治疗原发性开角型青光眼,能够有效降低眼压,改善视力,且无不良反应.     

Efficacy and safety of tafluprost 0.0015% and timolol maleate 0.5% fixed combination in patients with ocular hypertension or open-angle glaucoma

Introduction: Lowering intraocular pressure (IOP) is at present the only therapeutic approach to the treatment of glaucoma proven to be successful. The choice of therapy must take into account efficacy, tolerability, safety, quality of life, adherence and cost. Monotherapy fails to achieve a satisfactory IOP reduction in 40 – 75% of glaucoma patients after > 2 years of therapy. So far, three prostaglandin/timolol maleate 0.5% fixed combinations (FCs) are available.

Areas covered: This review provides a background on the tafluprost–timolol FC (TTFC, Santen Oy) and its individual compounds. It summarizes the data on efficacy and safety, including comparative data with prostaglandin/timolol FCs already available.

Expert opinion: Tafluprost is a preservative-free prostaglandin analog with a similar IOP efficacy when compared with other prostaglandin analogs. However, its improved adverse effect profile seems to be beneficial in patients sensitive to preservatives. The preservative-free TTFC has no market authorization yet. Only one Phase III trial was published so far, but results are promising in terms of efficacy, tolerability and safety. It is likely that the TTFC will play a role in the treatment of open-angle glaucoma and ocular hypertension.     

Brinzolamide/timolol fixed combination: a new ocular suspension for the treatment of open-angle glaucoma and ocular hypertension

For the treatment of open-angle glaucoma, the most frequent cause of irreversible visual loss, fixed combinations of different topical intraocular pressure (IOP) lowering molecules have gained an important role in recent years. The use of fixed combinations reduces the number of daily instillations, which promotes adherence to the prescribed medication and diminishes the exposition of the ocular surface to preservatives. The fixed combination of brinzolamide and timolol was recently approved by the European Medicines Agency (EMEA) and is now available in several countries in Europe. It contains two molecules widely used to treat glaucoma: timolol 0.5% (5 mg/ml) and brinzolamide 1% (10 mg/ml) in ophthalmic suspension formulation. This fixed combination is approved for twice-daily instillation to reduce elevated IOP in open-angle glaucoma and ocular hypertension. The brinzolamide/timolol fixed combination provides an approximately 30 – 33% IOP reduction from the untreated baseline IOP of 25 – 27 mmHg; thus, it is more potent than either of its ingredients alone. It is similarly effective but better tolerated than the dorzolamide/timolol fixed combination, which consists of molecules from the same pharmacological classes. The brinzolamide/timolol fixed combination can be used by itself as a separate therapy, but owing to the additivity of its ingredients to IOP-lowering drugs belonging to other classes, it may also be administered adjunctive to other IOP-reducing molecules, most importantly topical prostaglandin analogues. The ocular and systemic tolerance of the brinzolamide/ timolol fixed combination was reported favorable in Phase III studies, but no long-term clinical experience with this preparation is available at present.     

An evaluation of the fixed-combination of latanoprost and timolol for use in open-angle glaucoma and ocular hypertension

Glaucoma is one of the leading causes of irreversible blindness worldwide. Although there is no cure for this chronic disease, medical treatment is aimed at reducing levels of intraocular pressure (IOP) using ocular hypotensive agents. Very often, patients require more than one IOP-reducing drug, resulting in complex medication regimens that may be difficult to maintain and that can lead to non-compliance. A fixed-combination (FC) ophthalmic solution consisting of the prostaglandin, latanoprost (0.005%), and the β-blocker, timolol (0.5%), is now available. The primary mechanism of action of latanoprost is to increase uveoscleral outflow whereas timolol lowers IOP levels by decreasing the formation of aqueous humor in the ciliary epithelium. Due to the unique mechanism of action of latanoprost, once-daily dosing of one drop of FC latanoprost/timolol results in additional IOP reduction compared with either drug administered separately. FC latanoprost/timolol is well-tolerated and has a safety profile similar to that of its individual components. This combination drug provides a safe, effective and convenient alternative for the treatment of patients with elevated IOP levels uncontrolled with monotherapy.     

科比根治疗开角型青光眼和高眼压症的疗效及安全性

目的：研究科比根治疗开角型青光眼和高眼压症的疗效及安全性。方法采用对照研究手段,将符合条件的患者随机分组进行科比根?（溴莫尼定和噻吗洛尔固定复合滴眼液）和非固定联合制剂治疗（0．2％酒石酸溴莫尼定滴眼液及0．5％噻吗洛尔滴眼液）比较。结果在5周的对比治疗后,分析疗效、治疗安全性,科比根?治疗效果与非固定联合制剂治疗效果接近,未出现新的与治疗有关不良事件,未观察到其他治疗安全性的明显差异。结论科比根治疗开角型青光眼和高眼压症的方法与非固定联合制剂的疗效和安全性相似。     

Preservative-free versus preserved latanoprost eye drops in patients with open-angle glaucoma or ocular hypertension

Objective: This study compared the efficacy, safety, and pharmacokinetics of a preservative-free latanoprost formulation to an established, benzalkonium chloride (BAK) containing formulation for the treatment of open-angle glaucoma or ocular hypertension.

Methods: This was a phase II, randomized, cross-over, investigator-masked, multi-center, pilot study (NCT01494753). A total of 30 untreated adult patients (aged ≥18 years) with primary open angle glaucoma, pseudo-exfoliative glaucoma, pigmentary glaucoma, or ocular hypertension received either preservative-free or preserved latanoprost once daily in both eyes for 6 weeks, before crossing over to receive the other treatment. Efficacy (intraocular pressure [IOP] at 8 am, midday, 4?pm and 8?pm, and global efficacy assessment by investigator), safety (adverse events, ocular symptoms and global tolerance, slit lamp examination, funduscopy, visual field examination, visual acuity, and heart rate), and pharmacokinetics were assessed at Days 0, 42, and 84.

Results: Both treatments resulted in a reduction in IOP that was similar for the preservative-free and the preserved formulation at all time points. Similarly, the overall diurnal reduction was similar in both groups (6.3?mmHg [27.9% reduction] and 6.4?mmHg [28.1% reduction] for preserved and preservative-free latanoprost, respectively). There were no differences in global efficacy assessment or in the safety and tolerance of each treatment. Systemic concentrations of latanoprost were very low; AUC_0–30 and C_max were lower and t_max was longer for preservative-free latanoprost.

Conclusions: Preservative-free latanoprost showed similar efficacy at all time points compared to BAK preservative containing formulation, with no difference in tolerance, allowing progression to phase III clinical development.     

持续高眼压状态下手术治疗急性闭角型青光眼33例

目的探讨对降眼压治疗效果不佳的闭角型青光眼在高眼压状态下行手术治疗的疗效。方法回顾性分析笔者所在医院2007年5月～2010年10月治疗的33例33眼应用药物不能控制眼压的急性闭角型青光眼患者,所有患者均行复合式小梁切除术治疗。术后随访6～12个月。结果所有患者手术均顺利完成,术中术后均未出现严重并发症,术后视力获得明显的提高;术后1周所有患者眼压均在8～11mmHg,经6～12个月随访,患者眼压基本控制在14.36～21.58mmHg。结论原发性闭角型青光眼持续高眼压状态下的复合式小梁切除术是安全有效的。手术治疗的术前、术中、术后都应积极处理高眼压,提高手术的成功率,预防和减少术中及术后并发症的发生。     

IOP-lowering efficacy and tolerability of preservative-free tafluprost 0.0015% among patients with ocular hypertension or glaucoma

Abstract

Objective:

Tafluprost, the first preservative-free prostaglandin analogue for topical ophthalmic use to lower IOP, was introduced in Germany in 2008. After the approval for ophthalmic use, an open-label, multicentre, observational study was conducted between October 2008 and April 2009. Major objectives of this study were to evaluate the real world efficacy, local tolerability and safety of this first in class preservative-free prostaglandin preparation in patients with ocular hypertension and glaucoma.     

Preservative-free versus preserved brimonidine %0.15 preparations in the treatment of glaucoma and ocular hypertension: short term evaluation of efficacy,safety, and potential advantages

Abstract

Purpose: To compare the efficacy, safety, and potential advantages of the preservative-free versus preserved brimonidine %0.15 preparations in patients with primer open-angle glaucoma (POAG) or ocular hypertension (OHT).

Methods: Forty-two eyes of the 21 treatment-naive patients with POAG or OHT were enrolled in this study. Eyes were randomly assigned to receive brimonidine-purite 0.15% or preservative-free brimonidine 0.15% two times daily. Efficacy of the two eye drops was assessed by measuring the intraocular pressure (IOP) at 9–10 am at baseline and week 4. Safety and potential advantages of the drops were evaluated at weeks 4 in terms of ocular symptoms and tear parameters. Ocular symptom values of the patients were evaluated with a scale of 0–4 (0?=?no discomfort and 4?=?severe discomfort).

Results: Both of the brimonidine tartrate formulations resulted in statistically similar IOP reduction (preserved formulation; ?5.2?mmHg [22.9% reduction] preservative-free formulation; ?5.7?mmHg [24.1% reduction], p?=?0.37). It was found that brimonidine tartrate formulations with and without topical preservatives did not produce a statistically significant difference in pain, stinging, and blurred vision at the upon instillation (p?>?0.05). However, the burning sensation was significantly higher in the preservative-free formulation at the first instillation compared to the preserved formulation (p?=?0.01). Also, there was no statistically significant difference between the two formulations in terms of symptoms (itching, burning, tearing, stinging, and photophobia) and tear parameters during the day (p?>?0.05).

Conclusions: Although topical preservative-free brimonidine tartrate treated eyes had a more burning sensation at the first drop, the two formulations were similar in terms of ocular tolerability in the short term period. Also, both formulations were found to reduce IOP at a similar rate.     

氨氯地平治疗轻、中度高血压有效性与安全性的Meta分析

目的 :了解氨氯地平治疗轻、中度高血压有效性及不良反应 (安全性 )的差异。方法 :应用Meta分析对 2 6篇文献 2 8项研究氨氯地平与其他抗高血压药物治疗轻、中度高血压的有效性、安全性进行同质性检验及合并效应量的估计。结果 :(1)同质性检验 :有效性 ,χ2 =2 9.13,自由度为 2 7;安全性 ,χ2 =2 7.95 ,自由度为 2 4 ,两者P均大于 0 .0 5。 (2 )合并效应量的估计 :有效性 ,OR合并 =1.2 6 1,OR合并95 %可信区间为 1.0 18～ 1.5 6 2。OR合并 的检验 :χ2 =4 .5 1,P <0 .0 5 ;安全性 :OR合并 =1.0 13,OR合并95 %可信区间为 0 .80 1～ 1.2 82。OR合并 的检验 :χ2 =0 .0 13,P >0 .0 5。结论 :氨氯地平治疗轻、中度高血压的疗效总体上优于目前常用药物 ,且其安全性较高。     

Changes in intraocular pressure following a switch from latanoprost monotherapy to latanoprost/timolol fixed combination therapy in patients with primary open-angle glaucoma or ocular hypertension: results from a clinical practice database

ABSTRACT

Aims: To assess the incremental change in intraocular pressure (IOP) levels in patients with primary open-angle glaucoma or ocular hypertension, insufficiently treated with topical ocular hypotensive monotherapy or combination therapy and changed to the latanoprost/timolol fixed-combination therapy (LTFC).

Methods: The glaucoma database of the Glasgow Royal Infirmary was reviewed retrospectively to identify patients ≥?18 years of age with primary open-angle glaucoma or ocular hypertension in at least one eye who had been switched to LTFC from a previous monotherapy or combination therapy. Ninety patients were identified, and 59 (66%) had changed to LTFC from latanoprost monotherapy (LM). The analysis focused on this subgroup because few patients were changed from any other single therapy. At least one documented patient visit following the change to LTFC was required. The within-subject difference in IOP levels (IOP on LM–IOP on LTFC) was calculated for each case, and the statistical significance of the mean change in IOP was analysed using a 2-sided Student's paired t-test with a 0.05 α level.

Results: The mean decrease in IOP after changing to LTFC from LM was 2.6?mmHg (95% confidence interval?=?1.6, 3.6), from 21.4 (SD?=?3.5) mmHg to 18.8 (SD?=?4.2) mmHg (p?=?0.002).

Conclusions: LTFC provides significant incremental IOP reduction in patients with primary open-angle glaucoma or ocular hypertension who require additional IOP reduction following treatment with LM.