局部滴用拉坦前列腺素可增加小梁网通路房水引流  

Latanoprost instillation results in a rapid measurable increase in aqueous vein in primary open angle glaucoma

作　　者：辛晨[1] Xin Chen(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院、北京同仁眼科中心、眼科学与视觉科学北京市重点实验室,北京100730

出　　处：《眼科》2024年第4期257-260,共4页Ophthalmology in China

基　　金：国家重点研发计划“政府间国际科技创新合作”专项(2022YFE0132500)。

摘　　要：目的探究局部滴用拉坦前列腺素后早期眼压下降机制。设计单因素重复测量设计。研究对象初次局部使用拉坦前列腺素的原发性开角型青光眼患者15例(15眼)。方法分别于滴用拉坦前列腺素前、滴用后10、30、45、60、120、240分钟测量眼压,使用裂隙灯录像系统拍摄房水静脉录像5秒。主要指标眼压、房水宽度、房水流速。结果用药前眼压(28.3±4.2)mmHg,用药后120分钟开始下降至(24.3±2.3)mmHg(F=10.203,P=0.006)。用药前房水宽度为(0.019±0.010)μm,用药后45分钟开始增加至(0.034±0.007)μm(F=26.187,P<0.001),并持续显著增加至用药60分钟的(0.050±0.012)μm(F=20.723,P<0.001)。用药前房水流速为(2.1±0.5)μl/s,用药后30分钟开始增加至(2.6±0.6)μl/s(F=5.757,P=0.031),并于用药后45分钟(3.9±0.8)μl/s及60分钟(4.3±0.9)μl/s仍持续显著增加(F30-45=8.512,P30-45=0.011;F45-60=6.719,P45-60=0.021)。结论拉坦前列腺素通过增加小梁网通路房水引流量发挥早期降眼压作用。Objective To explore the mechanism for immediate IOP effects that occur from a single dose of latanoprost.Design One-factor repeated-measures design.Participants 15 eyes with primary open angle glaucoma were treated naively with latanoprost.Methods Intraocular pressure(IOP)and video imaging of aqueous vein were captured before and 10-min,30-min,45-min,60-min,120-min and 240-min after instillation of latanoprost.Main Outcome Measures IOP,aqueous stratum diameter(ASD)and aqueous velocity(AV).Results Before medication instillation,IOP was(28.3±4.2)mmHg.It started to dramatically decrease to(24.3±2.3)mmHg after 120 minutes(F=10.203,P=0.006).Before medication instillation,ASD was(0.019±0.010)μm.It started to dramatically increase to(0.034±0.007)μm after 45 minutes(F=26.187,P<0.001),which kept increasing to(0.050±0.012)μm until 60 minutes afterwards(F=20.723,P<0.001).Before medication instillation,AV was(2.1±0.5)μl/s.It started to dramatically increase to(2.6±0.6)μl/s after 30 minutes(F=5.757,P=0.031),which kept increasing to 4.3±0.9μl/s at 45-minute and(4.3±0.9)μl/s at 60 minutes as well(F30-45=8.512,P30-45=0.011;F45-60=6.719,P45-60=0.021).Conclusion Latanoprost increase aqueous through trabecular meshwork pathway resulting immediate IOP drop.(Ophthalmol CHN,2024,33:257-260)

关 键 词：拉坦前列腺素 眼压 房水宽度 房水流速 

分 类 号：R775[医药卫生—眼科]