他氟前列素对原发性开角型青光眼和高眼压症患者24小时眼压的影响

Effect of Tafluprost on 24-Hour Intraocular Pressure in Patients withPrimary Open Angle Glaucoma and Ocular Hypertension

目的:通过测量24 h眼压评估他氟前列素对原发性开角型青光眼(POAG)和高眼压症(OHT)患者的临床疗效。方法:系列病例研究。收集2018年1月至2019年3月在沈阳爱尔眼视光医院初次诊断的POAG和OHT患者22例(43眼),由医师对所有患者进行Icare HOME眼压计操作培训及认证,认证合格后使用Goldmann压平眼压计(GAT)测量眼压3次,然后由患者使用Icare HOME眼压计自我监测用药前24 h眼压,之后每天2100给予他氟前列素点眼1次,1个月后患者自我监测用药后24 h眼压。采用单因素方差分析和Bland-Altman分析比较医师使用GAT和患者使用Icare HOME眼压计测量眼压的一致性。采用配对t检验分析患者使用他氟前列素治疗前后各个时间点的眼压值、24 h眼压均值、峰值、谷值和波动值的变化。结果:医师使用GAT和患者使用Icare HOME眼压计测量眼压的平均值分别为(18.2±3.7)mmHg(1 mmHg=0.133 kPa)和(17.4±4.2)mmHg,差异无统计学意义(F=0.837,P=0.363)。Bland-Altman分析证明医师使用GAT和患者使用Icare HOME眼压计测量眼压具有良好的一致性。使用他氟前列素治疗1个月后,所有评估时间点的眼压均降低(均P<0.05),不同时间点眼压降低的范围为1.8~5.5 mmHg。用药前24 h眼压均值、峰值、谷值、波动值分别为(19.4±5.0)、(25.0±5.8)、(14.1±4.5)、(10.9±3.8)mmHg,用药后分别降低至(15.6±4.2)、(20.4±4.5)、(11.3±3.6)、(9.2±2.9)mmHg,差异均有统计学意义(t=9.450、9.636、5.939、3.137,均P<0.05)。结论:对于初次诊断的POAG和OHT患者,他氟前列素可明显降低24 h中所有评估时间点的眼压。

Objective:To evaluate the 24-hour efficacy of tafluprost on the reduction of intraocular pressure(IOP)in patients with primary open angle glaucoma(POAG)and ocular hypertension(OHT).Methods:In this case-series study,a total of 43 eyes of 22 newly diagnosed patients with POAG and OHT from Shengyang Aier Eye Hospital were enrolled.All patients were trained to use an Icare HOME tonometer to measure IOP by themselves.For the certificated patients,aphysician used GAT to measure their IOP three times,and then the patients used Icare HOME to measure 24-hour IOP by themselves.Patients was given tafluprost once a day at 2100.Icare HOME was used by the patients themselves to measure 24-hour IOP again one month later.A one-way ANOVA and Bland-Altman analysis were used to compare the consistency of the GAT used by a physician and the Icare HOME used by patients to measure IOP.A paired t test was used to compare IOP at each time point,the mean,the peak,the valley and the fluctuation of 24-hour IOP before and after treatment with tafluprost.Results:The mean IOPs measured with GAT by a physician and Icare HOME by patients were 18.2±3.7 mmHg(1 mmHg=0.133 kPa)and 17.4±4.2 mmHg,respectively,with no statistically significant difference(F=0.837,P=0.363).Bland-Altman analysis showed that there was a good consistency between GAT measured by a physician and Icare HOME measured by patients.IOP decreased at all time points of assessment after 1 month(all P<0.05).The range of IOP reduction at different time points was 1.8 to 5.5 mmHg(all P<0.05).The mean,the peak,the valley,and the fluctuation of IOP at baseline were 19.4±5.0,25.0±5.8,14.1±4.5 and 10.9±3.8 mmHg,respectively,and were reduced to 15.6±4.2,20.4±4.5,11.3±3.6 and 9.2±2.9 mmHg after treatment(t=9.450,9.636,5.939,3.137,all P<0.05).Conclusions:Tafluprost provides effective 24-hour IOP reduction in newly diagnosed patients with POAG and OHT.