青光眼临床研究现状与进展课件.pptVIP

193 例入组 2例入组后测出日间 IOP 21 mmHg 1例 neuro VF 190例接受随机化处理 12 例退出 178 例接受研究评估 79例分配到噻吗洛尔组 99例分配到溴莫尼定组 两者降压效果相仿 溴莫尼定治疗组患者视野进展率降低 www.A 非固定配方联合用药存在问题 患者需频繁点眼 洗出效应 防腐剂对眼表产生不可逆性损害 影响正常工作生活 患者依从性差 易出现眼压失控导致视功能损害 依从性(%) 每日滴眼次数 Green RN. Clin Ther. 1984;6:592-599 滴眼次数将影响依从性 一项对患者依从性的调查显示，每天给药一次或2次的患者具有良好的依从性，分别为73%和70%，当随着给药次数的增加，患者依从像逐渐下降，当给药次数增至每天4次时，患者用药依从性仅为42%。 眼药水的大部分都通过泪道排出 每滴眼药水体积30–50 μL 结膜囊容积大概7 μL 每眨眼1下就有大约2 μL药水从泪囊消除 7 μL 30–50 μL 洗出效应 洗出效应的影响 Chrai SS et al. J Pharm Sci. 1974; 63(3): 333-338 第一药效的流失(%) 眼部短时间内多次虽然可增加角膜前药物的浓度，但同时也增加了药物的流失，可能增加全身不良反应的风险。研究显示，眼睛局部多次给药时，为了减少药物的流失，每次给药需间隔5分钟以上。 9. 固定合剂降眼压效果临床研究 * A Consistently Low IOP Reduces Vision Loss This slide demonstrates the importance of maintaining a consistently low IOP over time. After surgery to reduce IOP, patients with IOP consistently below 18 mm Hg over the 6-year follow-up period had, on average, visual field progression close to zero. Mean IOP during this period in this group of patients was very low (12.3 mm Hg). At later time points during follow-up, the visual field worsened significantly more in patients with IOP of 18 or over at any visit compared with patients who always had IOP under 18. For example, the average visual field defect worsened more in patients with IOP 18 at 75 to 100% of visits (the mean IOP was 14.7 mm Hg in these patients) compared with patients with IOP under 18 mm Hg at all visits (the mean IOP was 12.3 mm Hg in these patients). Reference The advanced glaucoma intervention study (AGIS). 7. The relationship between control of intraocular pressure and visual field deterioration. The AGIS Investigators. Am J Ophthalmol. 2000;130:429-440. * CIGTS的目的：初始治疗选择药物或者手术对于新发现的OAG患者的长期效果比较 * * 方法：眼底立体照相随访5年 * 视野进展的相关因素研究：607例新诊断OAG患者随机接受药物或手术治疗，然后每6个月随访一次视野。 * * * * In creating a fixed combination, regardless of its components, there are clear practical and clinical benefits for combining more than 1 medication in a single bottle. The