多剤併用治療中の緑内障患者に対する0.1％ブリモニジン酒石酸塩点眼液への切り替え効果

Ocular hypotensive effect of switching from multiple medications to 0.1％ brimonidine tartrate

要約　目的：複数の薬物で加療中の緑内障患者で，1剤をブリモニジン点眼に切り替えた時の効果の報告。対象と方法：加療中の緑内障19例32眼を対象とした。男性18眼，女性14眼で，年齢は47～84歳，平均71歳である。内訳は，原発開放隅角緑内障22眼，原発閉塞隅角緑内障2眼，混合型緑内障2眼，落屑緑内障2眼，血管新生緑内障4眼である。3剤から5剤，平均3.8剤により治療中で，臨床的に効果が不十分と判定された。うち1剤を0.1％ブリモニジン酒石酸塩に切り替え，以後6か月間の眼圧を観察した。切り替え前の眼圧は，平均17.4±3.7mmHgであった。結果：切り替え後の平均眼圧は，1か月後15.6±2.8mmHg，3か月後15.9±3.1mmHg，6か月後15.8±2.9mmHgに下降した。結論：複数の薬物で加療中の緑内障患者で，1剤をブリモニジン点眼に切り替えた時，1か月後に眼圧下降効果が得られた。

Abstract.　Purpose：To report the ocular hypotensive effect of switching multiple medications to 0.1％ brimonidine in glaucoma patients. Cases and Method：This study was made on 32 eyes of 19 glaucoma patients. The series comprised 18 male and 14 female eyes. The age ranged from 47 to 84, average 71 years. There were primary open-angle glaucoma 22 eyes, primary angle-closure glaucoma 2 eyes, mixed glaucoma 2 eyes, exfoliation glaucoma 2 eyes, mixed type glaucoma 2 eyes, and neovascular glaucoma 4 eyes. They were receiving 3 to 5, average 3.8, medications. Due to insufficient response to treatment, one of the multiple mediations was switched to 0.1％ brimonidine tartrate. The intraocular pressure（IOP）averaged 17.4±3.7 mmHg before switching. Results：IOP decreased to average of 15.6±2.8 mmHg one month, 15.9±3.1 mmHg 3 months, and 15.8±2.9 mmHg 6 months after switching. Conclusion：IOP decreased significantly one month after switching one of multiple medications by topical brimonidine in glaucoma patients.