開放隅角緑内障患者でのプロスタグランジン関連点眼薬の変更症例あるいは他剤追加症例の検討

Outcome of continuation or changes in prostaglandin monotherapy for primary open-angle glaucoma

要約　目的：プロスタグランジン関連（PG）点眼薬の変更症例，他剤追加症例を後ろ向きに検討した。

対象と方法：PG点眼薬単剤使用中の原発開放隅角緑内障854例854眼を対象とした。PG点眼薬継続症例，変更症例，他剤追加症例に分けた。変更，追加症例ではその理由と点眼薬を調査した。

結果：継続症例87.5％，追加症例8.5％，変更症例4.0％だった。変更，追加症例の理由は，視野障害進行43.0％，眼圧下降不十分32.7％，副作用15.9％，ノンレスポンダー7.5％などであった。変更症例では他のPG点眼薬への変更，追加症例ではPG/β配合点眼薬への変更が最も多かった。

結論：1年間の経過観察ではPG点眼薬単剤からの変更，追加症例は12.5％だった。変更，追加の理由は視野障害進行と眼圧下降不十分が多かった。

Abstract　Purpose: To report the course of intraocular pressure（IOP）in patients with primary open-angle glaucoma（POAG）during continuation or changes in prostaglandin monotherapy.

Cases and Method: This retrospective study was made on 854 eyes of 854 cases of POAG treated by prostaglandin or its analogue. The series comprised 389 males and 465 females. The age ranged from 23 to 90 years, average 63 years. Cases were followed up for one year or longer.

Results: Medication with topical prostaglandin was continued in 747 cases（87.5％）. It was modified in 107 cases（12.5％）due to progression of visual field defect, insufficient decrease in IOP, side effects among others. Out of these 107 cases, 73 cases received additional medication including beta-blocking agents. The change was followed by significant decrease in IOP. The other 34 cases was switched to another prostaglandin preparation.

Conclusion: Prostaglandin monotherapy was modified by addition or switching to other medication during one year of treatment for POAG. The modification was mainly due to insufficient control of IOP or progression of visual field defect.