Intraocular pressure response to medication in a clinical setting: The Marshfield Clinic Personalized Medicine Research Project
Intraocular pressure response to medication in a clinical setting: The Marshfield Clinic Personalized Medicine Research Project
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DOI：
10.1097/ijg.0b013e31815c5f3f
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发表时间：
2008-08-01
影响因子：
2
通讯作者：
Patchett, Richard B.
中科院分区：
文献类型：
--
作者：
McCarty, Catherine A.;Mukesh, Bickol N.;Patchett, Richard B.
目的：估计青光眼和高眼压症的患病率，并描述治疗青光眼和高眼压症的局部药物的处方模式和眼压 (IOP) 反应的时间趋势。材料和方法：检索参加基于人群的马什菲尔德诊所个性化医疗研究项目的成人受试者的医疗记录，以确定已诊断为高眼压症或青光眼并开出降低 IOP 药物的参与者。记录使用眼压药物前后的所有眼压。 结果：截至2005年12月31日，18 773名成年人参加了个性化医疗研究项目，其中57.1%为女性，平均年龄为50.3岁（范围为18至101岁）。 50岁及以上受试者中确诊青光眼的总体率为2.1%（95%置信区间=1.2,2.4），高眼压症治疗率为1.4%（95%置信区间=1.2,1.7）。直到 2000 年，外用 β 受体阻滞剂一直是大多数受试者的处方药物，1995 年首次使用的前列腺素成为主要处方药物。 2005年，75%的受试者使用前列腺素类似物，46%的受试者使用外用β受体阻滞剂。处方后前 3 个月内，观察到前列腺素类似物的 IOP 相对降低幅度最大（平均相对降低 21.4%），其次是 β 受体阻滞剂（平均相对降低 20.9%）。在开始药物治疗之前，随着时间的推移，平均 IOP 显着下降（线性回归 beta 系数 = -0.30，P < 0.0001，r(2) = 0.09）。结论：在这个以临床为基础的环境中，我们发现青光眼的治疗在过去 20 年中发生了变化，眼科医生更有可能在较低的 IOP 基线水平开始治疗，而前列腺素类似物是最常用的处方药和降低眼压的药物。眼压。
Purpose: To estimate glaucoma and ocular hypertension prevalence and to describe temporal trends in prescribing patterns and intraocular pressure (IOP) response to topical medications used in glaucoma and ocular hypertension.Materials and Methods: The medical records of adult subjects enrolled in the population-based Marshfield Clinic Personalized Medicine Research Project were searched to identify participants who had been diagnosed with ocular hypertension or glaucoma and prescribed agent(s) to lower IOP. All IOPs before and after prescription of the IOP agents were recorded.Results: As of December 31, 2005, 18 773 adults were enrolled in the Personalized Medicine Research Project, 57.1% were female, and their mean age was 50.3 years (range, 18 to 101 y). The overall rate of definite glaucoma in Subjects aged 50 years and above was 2.1% (95% confidence interval = 1.2, 2.4) and the rate of treated ocular hypertension was 1.4% (95% confidence interval = 1.2, 1.7). Topical beta-blockers were the agents prescribed for the majority Of Subjects until the year 2000, when prostaglandins, first used in 1995, became the primary agent prescribed. In 2005, 75%, of subjects used prostaglandin analogs and 46% used topical beta-blockers. The largest relative reduction in IOP in the first 3 months after prescription was observed for prostaglandin analogs (21.4% mean relative reduction), followed by beta-blockers (20.9% mean relative reduction). There has been a significant decrease over time in mean IOP before initiating medical therapy (linear regression beta coefficient = -0.30, P < 0.0001, r(2) = 0.09).Conclusions: In this clinic-based setting, we found that treatment of glaucoma has changed over the past 20 years, with ophthalmologists more likely to begin treatment at lower baseline levels of IOP, and prostaglandin analogs the most commonly prescribed and agent to lower IOP.