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.     

溴莫尼定噻吗洛尔滴眼液治疗原发性开角型青光眼疗效与安全性分析

目的分析溴莫尼定噻吗洛尔滴眼液治疗原发性开角型青光眼患者的疗效与安全性。方法回顾性分析2015年1月至2018年1月于我院进行治疗的128例原发性开角型青光眼患者为研究对象,根据患者治疗方法分为A组45例(溴莫尼定噻吗洛尔滴眼液)治疗、B组42例(溴莫尼定滴眼液)和C组41例(噻吗洛尔滴眼液),对比3组患者治疗后总有效率、眼内压、眼内血流动力学指标、眼内病理变化和不良反应。结果治疗后6个月A组患者的总有效率明显高于B组(χ~2=4.240,P=0.039)和C组(χ~2=7.964,P<0.01),但B组和C组间差异无统计学意义(P>0.05);治疗6个月后3组患者的眼内压均低于治疗前,A组治疗后眼内压明显低于B组(t=-2.270,P=0.026)和C组(t=-2.368,P=0.020),B组和C组间差异无统计学意义(P>0.05);治疗后6个月A组患者阻力指数小于治疗前,且明显小于B组(t=-5.167,P<0.01)和C组(t=-4.632,P<0.01),但B组和C组组间、组内对比差异无统计学意义(P>0.05);治疗后6个月A组患者视网膜神经纤维层厚度厚于治疗前,且明显厚于B组(t=2.289,P=0.025)和C组(t=2.313,P=0.023),但B组和C组组间、组内对比差异无统计学意义(P>0.05);治疗后6个月A组患者的不良反应发生率低于B组(χ~2=3.981,P=0.046)和C组(χ~2=7.611,P=0.006),但B组和C间差异无统计学意义(P>0.05)。结论溴莫尼定噻吗洛尔滴眼液用于治疗原发性开角型青光眼能够显著降低眼内压,改善眼部的血流动力学,具有保护视神经,降低不良反应的作用,安全有效。     

不同滴眼液治疗原发性开角型青光眼的疗效比较

目的 观察不同滴眼液治疗原发性开角型青光眼的有效性差异。方法 回顾性选取2020年8月—2022年7月宜都市人民医院收治的150例原发性开角型青光眼患者病历资料,依据治疗方案不同分为Ⅰ组、Ⅱ组、Ⅲ组,每组50例。Ⅰ组采用溴莫尼定噻吗洛尔滴眼液治疗,Ⅱ组采用酒石酸溴莫尼定滴眼液治疗,Ⅲ组采用马来酸噻吗洛尔滴眼液治疗,持续滴眼4周为1个疗程,3组均持续用药3个疗程。比较3组患者治疗前与治疗1、3、6个月眼内压,治疗前与治疗6个月后视网膜中央动脉血流动力学指标、眼内病理变化及不良反应。结果 治疗1、3、6个月3组眼内压较治疗前均降低(P<0.01),且Ⅰ组低于Ⅱ组、Ⅲ组(P<0.05或P<0.01),Ⅱ组、Ⅲ组比较差异无统计学意义(P>0.05)。治疗6个月后,3组收缩末期血流速度与舒张末期血流速度治疗前后及各组间比较差异均无统计学意义(P>0.05),Ⅰ组阻力指数较治疗前降低,且Ⅰ组低于Ⅱ组、Ⅲ组(P均<0.01),Ⅱ组、Ⅲ组阻力指数治疗前后及组间比较差异无统计学意义(P>0.05);3组视盘盘沿面积、视野缺损治疗前后及各组间比较差异均无统计学意义...     

0.03%卢美根和0.5%噻吗心胺在治疗开角型青光眼和高眼压症中的比较

<正>青光眼治疗的主要目的是降低眼压,防止高眼压导致视神经萎缩以致视力丧失。目前降眼压的药物大多数是通过针对房水循环的不同环节来抑制房水的生成以达到降眼压的目的。近年来出现了一类具有独特的药理学特性的降眼压药物——前列腺素类药物,卢美根(bimatoprost)是其中的新成员[1,2],它是前列腺素的合成拟似物,通过对前列腺素F(PGF)     

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.     

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     

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.     

他氟前列素治疗开角型青光眼和高眼压症的有效性及安全性评价

目的:综述他氟前列素滴眼液降低开角型青光眼和高眼压症患者眼内压的有效性及安全性评价。方法:使用"他氟前列素"、"开角型青光眼"、"高眼压症"、"有效性"、"安全性"作为检索词在PubMed数据库和中文数据库维普全文、电子期刊等对已发表的文献进行检索,检索2004年至2015年英文文献共52篇及中文文献多篇,包括多中心临床研究及药品信息资料,并对检索结果进行归纳性分析。结果:现有的研究已显示,他氟前列素是一种有效降低眼内压的药物。循证医学也发现他氟前列素安全有效,患者依从性良好。不含防腐剂他氟前列素的降眼压效果与含防腐剂的相同。结论:研究提示,他氟前列素每日1次滴眼可安全有效地降低开角型青光眼及高眼压症患者的眼内压。     

曲伏前列素控制开角型青光眼昼夜眼压波动的效果观察

目的探讨曲伏前列素控制原发性开角型青光眼昼夜眼压波动的疗效。方法将32例（60眼）原发性开角型青光眼患者随机分为两组，16例（31眼）应用0．004％曲伏前列素每天1次滴眼，16例（29眼）应用0．25％噻吗心安每天2次滴眼，共治疗8周。结果用药后曲伏前列素组的夜间眼压及眼压波动值明显低于噻吗心安组，差异有统计学意义（均P〈0．001）；而白天平均眼压差异无统计学意义。结论曲伏前列素与噻吗心安相比，对夜间眼压及昼夜眼压波动控制效果更佳。     

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.     

A comparison of the safety and intraocular pressure lowering of bimatoprost/timolol fixed combination versus latanoprost/timolol fixed combination in patients with open-angle glaucoma*

ABSTRACT

Purpose: To compare the efficacy and tolerability of a once daily evening dose of the latanoprost/timolol fixed combination (LTFC) with that of a once-daily evening dose of the bimatoprost/timolol fixed combination (BTFC) in patients with open-angle glaucoma with elevated intrao­cular pressure (IOP) insufficiently responsive to mono­therapy with prostaglandin analogues/prostamides.

Design: Prospective, randomized, evaluator masked, single-center study.

Participants: 36 patients with a diagnosis of open-angle glaucoma, with or without pseudoexfoliation, and inadequate control of IOP, insufficiently responsive to monotherapy with prostaglandin analogues/prostamides.

Main outcome measure: The primary end-points were the change in IOP at 9:00?am from baseline to week 4, and the difference between treatment groups in the mean diurnal IOP reduction from baseline to week 4.

Results: BTFC provided significantly greater mean diurnal IOP reduction [mean (standard deviation)] 2.8 (0.9)?mmHg, compared with LTFC 2.1 (0.6)?mmHg, p = 0.0214. Both treatments significantly reduced the IOP from baseline at each IOP time-point measured, p < 0.0001, and for the mean diurnal IOP; p = 0.0049 for the LTFC, and p < 0.0001 for the BTFC. There were no significant differences in average hyperemia scores among groups, 1.25 (0.5) vs. 1.62 (0.69), p = 0.3835, for the LTFC and the BTFC, respectively.

Conclusions: The results of this study showed a significantly higher IOP-lowering effect of a once-daily evening dose of the BTFC compared to that of a once-daily evening administration of the LTFC.     

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.     

A comparative study on the efficacy, safety, and cost-effectiveness of bimatoprost/timolol and dorzolamide/timolol combinations in glaucoma patients

Aim:

This study was designed to compare the bimatoprost/timolol combination and dorzolamide/timolol combination in glaucoma for efficacy, safety, and cost-effectiveness in a local population of Trichy in the state of Tamilnadu.

Materials and Methods:

Eight-week, randomized, parallel group, open-label study was conducted on 48 patients of open angle glaucoma or ocular hypertension. After initial clinical assessment and baseline investigations, bimatoprost/timolol combination (Group A) was prescribed to 22 patients (2 patients lost after initial assessment) and dorzolamide/timolol combination (Group B) to 24 patients. The patients were reviewed after second and eighth weeks for cure rate and adverse drug reaction monitoring.

Results:

At the end of 8 weeks, the mean reduction in intraocular pressure from baseline was 13.04 mmHg (95% confidence interval (CI): 10.67–14.70) with bimatoprost/timolol combination once daily (P < 0.01) and 9.46 mmHg (95% CI: 7.47–10.5) with dorzolamide/timolol combination twice daily. Both the treatments were safe. Cost-effective range of bimatoprost/timolol combination was lower than that of dorzolamide/timolol combination.

Conclusion:

The fixed combination of bimatoprost/timolol was slightly more effective than that of dorzolamide/timolol combination in reducing IOP, and both treatments were generally well tolerated. Bimatoprost/timolol combination was more cost-effective (cost-effective analysis) than dorzolamide/timolol combination.     

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。     

Fixed combinations of dorzolamide-timolol and brimonidine-timolol in the management of glaucoma

Importance of the field: The emergence of fixed-combination drugs for the treatment of glaucoma has, to some extent, changed the medical management of glaucoma. The potential benefits of these drugs include a reduction in the total number of drops and preservatives instilled per day and improved patient comfort factors, which may contribute to better compliance. Combination medications may also improve therapeutic efficacy and play an important role in controlling medication cost. However, the fixed dosing may be a disadvantage in some cases.

Area covered in this review: This review describes the composition, pharmacokinetics, mode of action, efficacy, side effects, and safety profile of fixed-combination dorzolamide–timolol and fixed-combination brimonidine–timolol.

What the reader will gain: Understanding of the pros, cons, and safety profile of two FDA approved fixed-combination antiglaucoma medication.

Take home message: Fixed-combination medications may be a reasonable adjunct to prostaglandins if a large drop in the intraocular pressure (IOP) is desired and adding only one medication is unlikely to reach the target IOP range. Both mentioned drugs are effective in reducing the IOP and further clinical studies will help identify differences in efficacy between the two. The clinician must make an individualized assessment of the medication's risk-benefit profile for each patient.     

Signs and symptoms of ocular surface status in glaucoma patients switched from timolol 0.5% to brinzolamide 1%/timolol 0.5% fixed combination: a 6-month efficacy and tolerability,multicenter, open-label prospective study

Purpose: To examine the impact of switching glaucoma patients from timolol 0.5% to brinzolamide 1%/timolol 0.5% fixed combination (Brinz/Tim FC) on quality of life and on ocular surface status; to assess efficacy after the switch.

Methods: 6-month, multicenter, open-label, prospective, switch study in 119 early to moderate glaucoma patients. Intraocular pressure (IOP), tear film break-up time (TF-BUT), fluorescein staining and Glaucoma Symptom Scale (GSS) questionnaire were recorded at baseline and after 6 months.

Results: Median (interquartile range) IOP significantly decreased from 20 to 16 mmHg, independent of sex and age. Most patients (95.8%) reached an IOP < 18 mmHg. TF-BUT improved, with a negative weak correlation to age at baseline and at 6 months. The percentage of patients with no fluorescein staining improved. The quality of life recorded by GSS also improved, being related both to age and corneal staining.

Conclusion: Brinz/Tim FC is effective and well tolerated. In this study, patients switched to Brinz/Tim FC obtained further reduction in IOP with no effects on ocular surface status and improved quality of life perception: a better quality of life could determine a better adherence to prescribed therapy.