Efficacy of Ripasudil as a Second-line Medication in Addition to a Prostaglandin Analog in Patients with Exfoliation Glaucoma: A Pilot Study
Efficacy of Ripasudil as a Second-line Medication in Addition to a Prostaglandin Analog in Patients with Exfoliation Glaucoma: A Pilot Study
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DOI：
10.1007/s40261-017-0509-0
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发表时间：
2017-06-01
影响因子：
3.2
通讯作者：
Tanihara, Hidenobu
中科院分区：
文献类型：
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作者：
Matsumura, Riyo;Inoue, Toshihiro;Tanihara, Hidenobu
目的本研究旨在评估Rho激酶抑制剂利帕舒地尔作为剥脱性青光眼患者的二线药物的眼压（IOP）降低效果。方法回顾性队列研究纳入了在前列腺素类似物治疗的基础上以利帕舒地尔为二线药物治疗的脱落性青光眼患者，随访至少5个月。16名患者的27只眼睛被纳入研究；平均（+/-标准差）年龄为76.1 +/- 7.2岁（63-91岁）。基线IOPs是利帕舒地尔治疗前进行的三次IOP测量的平均值。统计分析采用配对t检验和Bonferroni校正。通过逐步多元回归分析分析相关背景因素。结果开始使用利帕舒地尔前、1-2个月后和5-6个月后的平均（+/-标准差）IOP水平分别为16.2 +/- 2.1、14.7 +/- 2.8和13.1 +/- 2.6 mmHg。这些水平差异显著（0个月vs 1-2个月p = 0.00019, 1-2个月vs 5-6个月p = 0.00087, 0个月vs 5-6个月p < 0.00001）。对所有27只眼的数据进行逐步多元回归分析显示，5-6个月时IOP的变化与前列腺素类似物治疗时间和年龄有关，但与基线IOP、视野缺损严重程度、IOP测量时间或假性晶状体状态无关。结论利帕舒地尔可显著降低脱落性青光眼患者的IOP，且效果在5个月内随时间延长而增强。
Objective This study aimed to assess the intraocular pressure (IOP)-lowering effects of ripasudil, a Rho kinase inhibitor, as a second-line medication in patients with exfoliation glaucoma.Methods This retrospective cohort study included patients with exfoliation glaucoma who received ripasudil as the second-line drug in addition to prostaglandin analogs, and were followed-up for at least 5 months. Twenty-seven eyes of 16 patients were enrolled; the mean (+/- standard deviation) age was 76.1 +/- 7.2 years (range 63-91 years). Baseline IOPs were the averages of three IOP measurements performed before ripasudil treatment. Statistical analyses used the paired t test with the Bonferroni correction. Relevant background factors were analyzed via stepwise, multiple regression analysis.Results The mean (+/- standard deviation) IOP levels prior to commencement of ripasudil, 1-2 months later, and 5-6 months later were 16.2 +/- 2.1, 14.7 +/- 2.8, and 13.1 +/- 2.6 mmHg, respectively. These levels differed significantly (p = 0.00019 for 0 versus 1-2 months, 0.00087 for 1-2 vs. 5-6 months, and < 0.00001 for 0 vs. 5-6 months). Stepwise multiple regression analysis on data from all 27 eyes showed that the change in IOP at 5-6 months was associated with the treatment time with prostaglandin analogs and age, but not with baseline IOP, the severity of the visual field defect, the timing of IOP measurement, or pseudophakic status.Conclusions Ripasudil significantly lowered IOP in patients with exfoliation glaucoma, and the effect thereof increased over time within 5 months.