Intraocular pressure-lowering effects of ripasudil in uveitic glaucoma, exfoliation glaucoma, and steroid-induced glaucoma patients: ROCK-S, a multicentre historical cohort study
Intraocular pressure-lowering effects of ripasudil in uveitic glaucoma, exfoliation glaucoma, and steroid-induced glaucoma patients: ROCK-S, a multicentre historical cohort study
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DOI：
10.1038/s41598-020-66928-4
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发表时间：
2020-06-25
影响因子：
4.6
通讯作者：
Inoue, Toshihiro
中科院分区：
文献类型：
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作者：
Futakuchi, Akiko;Morimoto, Takeshi;Inoue, Toshihiro
为了评估利帕舒地尔治疗继发性青光眼的有效性和安全性，在日本的18个中心进行了一项历史队列研究。在2014年至2018年期间，由于三种继发性青光眼亚型，包括青光眼（UG）、脱落性青光眼（EG）或类固醇性青光眼（SG），需要额外降低眼压并局部接受0.4%利帕舒地尔治疗的成年人（年龄>= 20岁）在接受利帕舒地尔额外治疗之前的平均眼压变化。我们进一步评估了每个青光眼亚型的IOP变化，每个队列的基线特征，UG眼睛中葡萄膜炎引起的炎症的病程，以及每个队列中发生不良事件的患者比例。在符合本研究条件的332例患者的332只眼睛中，1、3和6个月的平均总IOP较基线分别为-5.86 +/- 9.04mmHg（-19.4 +/- 25.1%）、-6.18 +/- 9.03mmHg（-20.0 +/- 27.1%）和-7.00 +/- 8.60mmHg（-23.4 +/- 25.6%）。这些变化都具有统计学意义。332只眼中，109只眼为UG， 181只眼为EG， 42只眼为SG。利帕舒地尔在UG和SG组的降血压作用在各时间点均显著大于EG组。这一发现可能与UG和SG较高的基线IOP水平有关。UG患者经利帕舒地尔治疗后，前段平均细胞评分明显降低。无严重不良事件报告。这些结果表明，利帕舒地尔治疗继发性青光眼是一种安全有效的降低IOP的治疗方式。
To evaluate the efficacy and safety of ripasudil for treatment of secondary glaucoma, a historical cohort study was conducted at 18 centres in Japan. Adults (age >= 20 years) who needed additional IOP reduction and received topical 0.4% ripasudil between 2014 and 2018 due to three secondary glaucoma subtypes, including uveitic glaucoma (UG), exfoliation glaucoma (EG) or steroid-induced glaucoma (SG) were assessed for mean IOP change from baseline prior to additional treatment with ripasudil. We further evaluated the IOP change in each glaucoma subtype, baseline characteristics of each cohort, course of uveitis-induced inflammation in UG eyes, and proportion of patients in each cohort with adverse events. In 332 eyes from 332 patients eligible for this study, the mean overall IOP reductions from baseline at 1, 3, and 6 months were -5.86 +/- 9.04mmHg (-19.4 +/- 25.1%), -6.18 +/- 9.03mmHg (-20.0 +/- 27.1%), and -7.00 +/- 8.60mmHg (-23.4 +/- 25.6%), respectively. These changes were all statistically significant. Of 332 eyes, 109 eyes had UG, 181 had EG, and 42 eyes had SG. The IOP-lowering effects of ripasudil in UG and SG were significantly greater than those of EG at every time point. This finding could have been related to higher baseline IOP levels in UG and SG. UG patients exhibited significant decreases in mean cell score of the anterior segment after ripasudil treatment. No severe adverse events were reported. These findings suggest that treatment with ripasudil is a safe and effective therapeutic modality for IOP reduction in secondary glaucoma.