Changes in Corneal Biomechanical Properties after Long-Term Topical Prostaglandin Therapy.
Changes in Corneal Biomechanical Properties after Long-Term Topical Prostaglandin Therapy.
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长期局部前列腺素治疗后角膜生物力学特性的变化
DOI：
10.1371/journal.pone.0155527
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Sun X
中科院分区：
文献类型：
--
作者：
Wu N;Chen Y;Yu X;Li M;Wen W;Sun X
比较通过一种新开发的眼压计（角膜可视化Scheimpflug技术，Corvis ST）测量的原发性开角型青光眼（POAG）未治疗患者、长期使用局部前列腺素类似物（PGA）治疗的POAG患者以及正常对照者的角膜生物力学特性。进一步研究PGA对角膜生物力学的潜在影响。
在这项病例对照研究中，纳入了35只连续的未用药的POAG患眼、34只至少接受2年PGA治疗的POAG患眼以及19只正常眼。使用Corvis ST测量眼内压（IOP）、中央角膜厚度（CCT）以及角膜生物力学参数，包括变形幅度（DA）、压平时间（AT1和AT2）、压平长度（AL1和AL2）、压平速度（AV1和AV2）以及峰距和半径。使用部分相干干涉测量法（IOLMaster，蔡司，德国）测量眼轴长度和角膜曲率。进行一般线性模型分析以研究正常对照者、新诊断的POAG患者以及长期接受PGA治疗的POAG患者之间，以及不同类型PGA治疗亚组（包括比马前列素、拉坦前列素和曲伏前列素）之间角膜生物力学特性的变化。此外，还采用Bonferroni校正最小二乘均值进行两两比较。
在调整年龄和性别后，新诊断的青光眼患者的AT1（p<0.0001）、AV1（p<0.0001）、AT2（p = 0.0001）、AV2（p<0.0001）和DA（p = 0.0004）与正常受试者以及至少接受2年局部PGA治疗的患者有显著差异。在调整年龄、性别、IOP、CCT、眼轴长度和角膜曲率后，未接受PGA治疗的青光眼患者和长期接受PGA治疗的患者之间的DA存在显著差异（p = 0.0387）。此外，在比马前列素、拉坦前列素和曲伏前列素这3种PGA治疗亚组之间，所有角膜生物力学参数均无统计学显著差异。
在未治疗的POAG患者、长期使用局部PGA治疗的POAG患者和正常对照者之间发现角膜变形参数有显著变化。长期局部PGA治疗除了因PGA导致的IOP降低和CCT下降对角膜动态特性产生间接影响外，可能还对角膜生物力学特性有直接影响。
Objective To compare corneal biomechanical properties, measured by a newly developed tonometer (Corneal Visualization Scheimpflug Technology, Corvis ST), in untreated primary open angle glaucoma (POAG) patients, POAG patients with long-term topical prostaglandin analog (PGA) therapy and in normal controls. Further is to investigate the potential effects of PGA on corneal biomechanics. Methods In this case-control study, 35 consecutive medication naïve eyes with POAG, 34 POAG eyes with at least 2 years treatment by PGA and 19 normal eyes were included. Intraocular pressure (IOP), central corneal thickness (CCT) and corneal biomechanical parameters, including deformation amplitude (DA), applanation time (AT1 and AT2), applanation length (AL1 and AL2), applanation velocity (AV1 and AV2), and peak distance and radius were measured using Corvis ST. Axial length and corneal curvature were measured with partial coherence interferometry (IOLMaster, Zeiss, Germany). General linear model analysis was performed to investigate the corneal biomechanical property changes among the normal controls, newly diagnosed POAG patients and POAG patients with long-term PGA treatment, and among the subgroups of different types of PGA treatment, including bimatoprost, latanoprost and travoprost. Furthermore, pairwise comparisons using Bonferroni correction for least squares means were employed. Results AT1 (p<0.0001), AV1 (p<0.0001), AT2 (p = 0.0001), AV2 (p<0.0001) and DA (p = 0.0004) in newly diagnosed glaucoma patients were significantly different from those in normal subjects and in patients underwent at least 2 years topical PGA therapy after adjusting for age and gender. After adjusting for age, gender, IOP, CCT, axial length and corneal curvature, a significant difference was detected for DA between glaucoma patients without PGA treatment and patients with long-term PGA therapy (p = 0.0387). Furthermore, there were no statistical significant differences in all of the corneal biomechanical parameters among the 3 types of PGA therapy subgroups, namely bimatoprost, latanoprost and travoprost. Conclusions Significant changes in corneal deformation parameters were found among untreated POAG patients, POAG patients with long-term topical PGA therapy and normal controls. Long-term topical PGA treatment might have a direct effect on corneal biomechanical properties in addition to the indirect effect owing to the PGA-induced IOP reduction and CCT decrease on corneal dynamic properties.