ドルゾラミド塩酸塩/チモロールマレイン酸配合剤からブリンゾラミド塩酸塩，チモロール単剤併用に切り替えた眼圧変化

Changes in intraocular pressure after switching from fixed combination of dorzolamide/timolol to brinzolamide and timolol

要約　目的：配合剤から単剤併用に切り替えた眼圧変化の後ろ向き報告。対象と方法：ドルゾラミド塩酸塩/チモロールマレイン酸塩配合剤（DTFC）使用中の眼刺激症状を訴える正常眼圧緑内障15例27眼を対象。男性3例，女性12例，平均年齢は72.8±8.5歳。DTFCから眼刺激症状の少ないブリンゾラミド懸濁性点眼液を選択し単剤併用とし，6か月間の眼圧経過とアドヒアランスについて調べた。結果：切り替え後，全経過において有意な眼圧下降を得た。点眼回数増加にもかかわらず良好なアドヒアランスであった。結論：アドヒアランスに関しては眼刺激症状の改善も重要な因子であり，単剤併用においてさらなる眼圧下降が得られる可能性がある。

Abstract.　Purpose：To report changes in intraocular pressure（IOP）after switching from fixed combination of dorzolamide/timolol to concomitant instillation of 1％ brinzolamide and 0.5％ timolol. Cases and Method：This retrospective study was made on 27 eyes of 15 patients with normal-tension glaucoma. The series comprised 3 males and 12 females. The age averaged 72.8±8.5 years. All the cases reported irritation after instillation of dorzolamide/timolol. The treatment was switched to brinzolamide and timolol. Patients were followed up for 6 months after switching regarding IOP and adherence to treatment. IOP averaged 13.9±1.9 mmHg in the series. Results：Averaged value of IOP decreased significantly for every months until 6 months after switching（p＜0.05）. The patients showed excellent adherence to treatment in spite of increased medications. Conclusion：Patients' adherence and decreased irritation are important factors in the treatment of glaucoma. Switching of medication also resulted in more ocular hypotension.