依据24h眼压峰值的青光眼个性化药物治疗观察  

Personalized drug treatment for glaucoma based on the peak value in 24 hours' intraocular pressure measurement

作　　者：肖明 孙兴怀[2] 孟樊荣[2] 房召彬 钱韶红[2] 邱思羽 

机构地区：[1]上海市闸北区北站医院眼科,上海200070 [2]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2012年第1期36-39,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：上海市闸北区科委重点课题项目(2007重点13);卫生部部属医院2010-2012年度临床学科重点项目(2011036)

摘　　要：目的通过对开角型青光眼患者进行24h眼压监测后采用不同的降眼压用药时间,来探索青光眼的个性化治疗。方法入选18例正常眼压性青光眼和14例原发性开角型青光眼,治疗前均给予视野检查,进行24h眼压监测(每2h1次),并根据眼压波动曲线,给予前列腺素类降眼压药,1次/d,用药时间为峰值眼压提前12h;1个月后复查24h眼压,随访(23.7±12.4)个月,记录随访终末期的视野。结果治疗前平均眼压(16.8±3.5)mm Hg(1mm Hg=0.133kPa),峰值眼压(20.8±4.6)mm Hg,谷值眼压(13.7±3.1)mm Hg,眼压波动值(7.1±2.4)mm Hg;治疗后平均眼压(13.2±2.6)mm Hg,峰值眼压(16.4±3.4)mm Hg,谷值眼压(10.7±2.3)mm Hg,眼压波动值(5.7±2.1)mm Hg。治疗前后平均眼压、峰值眼压、谷值眼压、眼压波动值的差异均具有统计学意义(P<0.0001)。治疗前视敏度(19.0±5.2)dB,视敏度缺损值(8.2±4.9)dB;治疗后视敏度(19.7±5.5)dB,视敏度缺损值(7.2±5.1)dB。结论通过依据24h眼压峰值来确定青光眼的用药及其用药时点的选择,以及青光眼随访过程中治疗药物的调整,是一种值得推广的青光眼个性化治疗模式。Objective To investigate the personalized treatment for open angle glaucoma By changing the time of intraocular pressure-lowering medication after 24 hours＇ monitoring of intraocular pressure （IOP）. Methods Eighteen normal tension glaucoma patients and 14 primary open angle glaucoma patients were included. Visual field examination and 24 hours＇ IOP measurement （one time every two hours） was performed before treatment. Based on the IOP curve, prostaglandin analogues were given 12 hours before the peak value, one time one day. One month later, 24 hours＇ IOPmonitoring was repeated. The mean follow-up was （23.7 ± 12.4）months. At the end of follow up, visual field examina- tion was repeated. Results Before treatment, the mean IOP was 16.8 ±3.5 mm Hg（ 1 nan Hg =0. 133 kPa）, the peak IOP was （20.8 ±4.6）mm Hg, the valley IOP was （13.7 ±3.1）mm Hg, and the IOP fluctuation was （7.1 ±2.4） mm Hg. After treatment, the mean IOP was （13.2 ±2.6） mm Hg, the peak IOP was （16.4 ±3.4） mm Hg, the valley IOP was （10.7 ± 2.3）nun Hg, and the fluctuation value of IOP was （5.7 ± 2. 1 ） mm Hg. The differences in mean IOP, peak IOP, valley IOP and IOP fluctuation before and after treatment were all of statistic significance （P 〈 0. 000 1 ）. Be- fore treatment, the mean sensitivity of the visual field was （ 19.0 ± 5.2） dB and the mean defect was （8.2 ± 4.9） dB. Af- ter treatment, the mean sensitivity was （ 19.7 ± 5.5） dB and the mean defect was （7.2 ± 5.1 ） dB. Conclusions Deter- mination of the time for medication and adjustment of eyedrops during follow-up could base on the peak value in 24 hours＇ IOP monitoring. We think it is worth promoting for personalized glaucoma treatment. （ Chin J Ophthalmol and Otorhinolaryngol,2012,12：36-39）

关 键 词：24小时眼压 峰值眼压 开角型青光眼 个性化药物治疗 

分 类 号：R775[医药卫生—眼科]