苏为坦和贝他根治疗原发性开角型青光眼的临床比较研究

目的:比较苏为坦和贝他根在治疗原发性开角型青光眼的疗效,以更好地指导临床应用。方法:本院2008-12/2010-12共46例46眼原发性开角型青光眼患者入选本研究,其中苏为坦组23例,贝他根组23例,两组分别使用苏为坦和贝他根滴眼液,每晚点药1次(1滴/次),治疗周期为12wk,每月随访1次。每日取5个时间节点,比较两组在治疗前后的眼压变化,观察不良反应,应用SPSS16.0软件进行统计学分析。结果:两组患者用药12wk后眼压均明显下降,苏为坦组眼压从24.3±2.02mmHg降至16.1±1.34mmHg,贝他根组眼压从24.99±1.38mmHg降至15.56±0.68mmHg,波幅下降幅度(用药前后波幅差值/用药前波幅值),苏为坦组为36.7%,贝他根组为35.8%,用药前后各时间节点中,两组间的眼压值变化,在夜间12:00苏为坦组眼压下降优于贝他根组(F=4.25,P=0.045),而其他时间节点两组变化差异无统计学意义。结论:苏为坦和贝他根治疗原发性青光眼降眼压疗效明显平稳,无明显毒副作用,苏为坦在降低夜间眼压方面优于贝他根。     

曲伏前列素和噻吗心安治疗开角型青光眼和高眼压症的对照研究

目的:以噻吗心安为对照,观察曲伏前列素滴眼液降眼压效果及安全性。方法:采用随机对照法,0.04g/L曲伏前列素滴眼液1次/d或5g/L噻吗心安滴眼液2次/d,治疗原发性开角型青光眼和高眼压症,共34例,疗程12wk,观察眼压及不良反应。未发现其他眼部改变和全身副作用。结果:试验组平均日间眼压以24.83±2.97mmHg降至16.13±2.92mmHg;对照组从23.96±3.62mmHg降至16.14±2.97mmHg。试验组结膜充血较对照组明显增加。结论:曲伏前列素滴眼液对控制原发性开角型青光眼和高眼压症的眼压是有效和安全的。     

国产酒石酸溴莫尼定滴眼液的降眼压作用

目的:比较国产酒石酸溴莫尼定滴眼液(brimonidinetar-trateeyedrops)与进口同类药品阿法根滴眼液治疗青光眼和高眼压症的临床疗效及安全性。方法:原发性开角型青光眼或高眼压症患者240例,多中心随机双盲分成试验组(2g/L国产酒石酸溴莫尼定滴眼液)和对照组(阿法根滴眼液)。两组均每日点药2次(08∶00和20∶00),每次1滴。将点第1滴药后2h的眼压及连续点药后1,2,4wk的眼压与基线眼压进行比较研究,同时观察血压、心率等全身及局部副作用。结果:试验组点药前平均眼压为23.74±4.77mmHg,点1滴药后2h平均眼压为19.38±4.51mmHg(下降17.58%),连续点药1wk平均眼压为18.34±4.57mmHg(下降22.19%),2wk平均眼压为18.42±4.32mmHg(下降21.73%),4wk平均眼压为18.56±4.46mmHg(下降21.06%);对照组点药前平均眼压为24.54±5.66mmHg点1滴药后2h平均眼压为20.60±5.70mmHg(下降15.46%),连续点药1wk平均眼压为19.79±6.50mmHg(下降18.82%),2wk平均眼压为19.46±5.05mmHg(下降19.59%),4wk平均眼压为19.73±5.68mmHg(下降18.73%),经统计学处理两组之间降眼压效果无显著性差异。试验组和对照组均无明显的局部和全身不良反应发生。结论:国产2g/L酒石酸溴莫尼定滴眼液与阿法根滴眼液用于治疗原发性开角性青光眼与高眼压症,两者降眼压效果相似,全身和局部副作用小。     

国产拉坦前列腺素治疗开角型青光眼和高眼压症的疗效及安全性

目的:观察国产拉坦前列腺素滴眼液(见康)治疗开角型青光眼和高眼压症的临床疗效及安全性。方法:采用随机、单盲对照研究。原发性开角型青光眼或高眼压症的患者90例随机分三组,试验组:国产0.05g/L拉坦前列腺素(见康);对照组1:进口0.05g/L拉坦前列腺素(适利达);对照组2:0.04g/L曲伏前列素(苏为坦),每组30例患者。三组患者均9:00pm给药1次,疗程4wk。结果:用药2wk后,三组间治疗后眼压差异无统计学意义(P=0.673)。治疗4wk后,三组日眼压曲线各时间点眼压下降值差异无统计学意义。三组病例中均有轻度结膜充血的患者,试验组4例(13%),对照组1:3例(10%),对照组2:8例(27%)。结论:国产拉坦前列素滴眼液(见康)可有效降低眼压,安全性好,为治疗开角型青光眼及高眼压症提供了新的选择。     

国产和进口拉坦前列素滴眼液治疗开角型青光眼及高眼压症的疗效及成本比较

目的:观察国产拉坦前列素滴眼液降眼压效果及安全性,研究进口和国产拉坦前列素滴眼液的成本—效果比。方法:采用随机、单盲、平行对照试验,选取原发性开角型青光眼和高眼压症患者,18例18眼滴用国产拉坦前列素滴眼液,14例14眼滴用进口拉坦前列素滴眼液(适利达),均每日1次,共4wk。观察眼压、视力、血压、脉搏、眼部症状和体征以及不良反应。并采用疗效观察和成本—效果分析方法对进口与国产拉坦前列素滴眼液进行经济学评价。结果:治疗4wk,验证组平均日间眼压从(24.0±3.6)mmHg(1mmHg=0.133kPa)降至(16.1±3.0)mmHg,最大下降幅度为32.9%;对照组从(24.8±3.0)mmHg降至(16.1±2.9)mmHg,最大下降幅度为35.1%。两组用药前后眼压相比均显著差异(P<0.05);各时间点两组间眼压相比均无统计学差异(P>0.05)。用药后验证组和对照组结膜充血均有明显增加,但不妨碍继续用药。未发现其他眼部改变和全身副作用。两组成本分别为119元、70元(P<0.05);眼压下降幅度分别为35%,33%(P>0.05);成本—效果比分别为3.39,2.11;进口组相对于国产组的增量成本—效果比为22.2。结论:进口与国产拉坦前列素滴眼液都能有效地降低开角型青光眼及高眼压症患者的眼内压,且安全、耐受。两组治疗开角型青光眼及高眼压症的效果相近,但国产品是更经济的选择。     

1%派立明滴眼液联合0.25%贝特舒混悬液的临床降眼压疗效及安全性观察

目的:观察派立明滴眼液联合贝特舒混悬液对中国人青光眼患者的降眼压疗效及安全性方法:选取原发性开角型青光眼、高眼压症、术后残余青光眼患者共26例44只眼,给予派立明滴眼液及贝特舒混悬液早晚各2次点眼,共观察2个月,分别于用药后2周、4周、6周、8周复查,观察用药前后的眼压及不良反应。结果:派立明联合应用贝特舒每日2次点眼,降眼压效果显著且稳定,眼压平均降低5.03～6.65mmHg(1mmHg=0.133kPa),平均降幅为20.55%～37.30%且不良反应少。结论:派立明滴眼液联合贝特舒混悬液对中国人具有良好的降眼压效果,毒副作用少,可作为临床上青光眼药物治疗的主要用药。     

酒石酸溴莫尼定0．15％滴眼液治疗开角型青光眼及高眼压症的临床研究

目的评价0．15％酒石酸溴莫尼定（阿法舒）滴眼液降眼压的有效性和安全性。方法初诊原发性开角型青光眼或高眼压症46例（86只眼）单用或联合应用阿法舒滴眼液,3次／d,每次1滴。将连续滴药后2、4、8、12周的眼压与基线眼压进行比较研究,同时观察全身及局部副作用。结果使用阿法舒滴眼液后眼压均明显下降。由（22．89±3．91）mmHg（1mmHg=0．133kPa）分别下降为滴药后2、4、8、12周的（19．43±2．84）mmHg、（19．43±3．44）mmHg、（18．98±3．17）mmHg和（18．87±2．83）mmHg,用药后与治疗前比较差异均有统计学意义（P〈0．01）。初诊单纯使用阿法舒者,及换用或加用阿法舒者用药后与治疗前比较差异均有统计学意义（P〈0．01）。不良反应均为轻度。结论阿法舒滴眼液能显著降低原发性开角型青光眼及高眼压症患者的眼压,有效并且安全。     

新型前列腺素类抗青光眼药物--苏为坦

苏为坦TM,其活性成份为0．004％的曲伏前列素 (travoprost),是一种无色透明或者微黄色的溶液,适用于开角型青光眼和高眼压症。国外的临床研究认为,应用苏为坦后眼压平均下降7-8mmHg。药物在给药后的2小时发挥作用, 在12小时达到最大,因此建议在晚上8时睡觉前用药,到次日早晨眼压最高的时候发挥药物的最大疗效。苏为坦是前列腺素PGF2α的类似物,对FP前     

曲伏前列素滴眼液(速为坦)治疗原发性开角型青光眼和高眼压症的临床研究

目的观察曲伏前列素滴眼液(速为坦)降眼压效果及安全性。方法采用随机、单盲、平行对照试验,选取原发性开角型青光眼和高眼压症患者,试验组入选24例(24只眼)滴用曲伏前列素滴眼液,对照组入选23例(23只眼)滴用拉坦前列素滴眼液(适利达),均为每日1次,共观察4周。观察的指标包括眼压、视力、血压、脉搏、眼部症状和体征以及不良反应。结果1试验组平均日间眼压从(2483±297)mmHg(1mmHg=0133kPa)降至(1613±292)mmHg,最大下降幅度为352%;对照组从(2396±362)mmHg降至(1614±297)mmHg,最大下降幅度为326%。2用药后试验组和对照组结膜充血均有明显增加,试验组的眼痒明显重于对照组,但都不妨碍继续用药。未发现其他眼部改变和全身副作用。结论曲伏前列素滴眼液对控制原发性开角型青光眼和高眼压症的眼压是有效和安全的,可望成为理想的一线抗青光眼药物。     

三种前列腺素类药物降眼压效果比较

目的比较拉坦前列素、曲伏前列素和贝美前列素三种前列腺素类药物的降眼压效果。方法选取原发性开角型青光眼和高眼压症患者,拉坦前列素组51例(51眼),曲伏前列素组24例(24眼),贝美前列素组27例(27眼),分别使用相应滴眼液,均为每日1次,共观察4周,测量用药前后的眼压值。结果三组患者用药4周后眼压均有明显下降,拉坦前列素组在8:30测得平均眼压从(24.57±3.68)mmHg(1 mmHg=0.133 kPa)降至(15.29±2.67)mmHg,下降幅度(用药前后眼压差值/用药前眼压值)为37.8%;曲伏前列素组从(24.54±2.95)mmHg降至(16.29±3.11)mmHg,下降幅度为33.6%;贝美前列素组从(25.41±3.63)mmHg降至(16.00±4.45)mmHg,下降幅度为37.0%。用药前及用药后三组间眼压值比较,差异均无显著性(分别为F=0.579、P=0.562;F=0.868、P=0.423)。结论拉坦前列素、曲伏前列素、贝美前列素滴眼液对于原发性开角型青光眼和高眼压症患者都有明显、持久的降眼压作用,且降眼压作用相互间没有明显差异。     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

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Effects of Adenosine Agonists on Intraocular Pressure and Aqueous Humor Dynamics in Cynomolgus Monkeys

The effects of single or multiple topical doses of the relatively selective A₁adenosine receptor agonists (R)-phenylisopropyladenosine (R-PIA) and N⁶-cyclohexyladenosine (CHA) on intraocular pressure (IOP), aqueous humor flow (AHF) and outflow facility were investigated in ocular normotensive cynomolgus monkeys. IOP and AHF were determined, under ketamine anesthesia, by Goldmann applanation tonometry and fluorophotometry, respectively. Total outflow facility was determined by anterior chamber perfusion under pentobarbital anesthesia. A single unilateral topical application of R-PIA (20–250 μg) or CHA (20–500 μg) produced ocular hypertension (maximum rise=4.9 or 3.5 mmHg) within 30 min, followed by ocular hypotension (maximum fall=2.1 or 3.6 mmHg) from 2–6 hr. The relatively selective adenosine A₂antagonist 3,7-dimethyl-1-propargylxanthine (DMPX, 320 μg) inhibited the early hypertension, without influencing the hypotension. Neither 100 μg R-PIA nor 500 μg CHA clearly altered AHF. Total outflow facility was increased by 71% 3 hr after 100 μg R-PIA. In conclusion, the early ocular hypertension produced by topical adenosine agonists in cynomolgus monkeys is associated with the activation of adenosine A₂receptors, while the subsequent hypotension appears to be mediated by adenosine A₁receptors and results primarily from increased outflow facility.