リパスジル点眼液による眼圧下降効果の検討

Ocular hypotensive effect of ripasudil ophthalmic solution

要約　目的：リパスジル点眼液の眼圧下降効果と，効果に関与する因子の検討。

対象と方法：新規にリパスジル点眼液を追加（追加群），変更（変更群）投与し，3か月間経過観察可能であった緑内障108例162眼。両群の眼圧下降および下降率，病型および使用薬剤数別眼圧下降効果の比較，眼圧下降率に寄与する因子を検討した。

結果：両群で有意な眼圧下降を認めたが，病型および使用薬剤数別の下降率には差はなかった。有意な寄与因子は追加群では追加前眼圧高値，変更群では変更前眼圧高値，若い年齢，緑内障手術既往なしであった。

結論：リパスジル点眼液の追加・変更は有意な眼圧下降を認めた。追加・変更前眼圧が高いほど下降率が高い可能性がある。

Abstract　Purpose: To report the ocular hypotensive effect of 0.4％ ripasudil ophthalmic solution in eyes with glaucoma.

Cases and Method: This retrospective study was made on 162 eyes of 108 cases who received ripsudil and who were followed up for 3 months or longer. Ripasudil was started as addition to the previous treatment in 121 eyes and as replacement from previous glaucoma treatment in 41 eyes. The age averaged 64.9 in the former group and 60.6 years in the latter. There were 50 male and 32 females in the former group and 21 male and 14 females in the latter.

Results: Both groups showed significant reduction in intraocular pressure（IOP）. There was no difference in the hypotensive effect regarding the type of glaucoma or number of drugs. Ocular hypotensive effect was more pronounced in eyes with higher initial IOP when used as addition to previous treatment, and in eyes with higher IOP level before switching, younger age, and absence of previous glaucoma surgery when used as as switching.

Conclusion: Treatment with ripasudil ophthalmic solution was followed by ocular hypotensive effect when used as addition or replacement to previous glaucoma treatment. IOP reduction was more pronounced in eyes with high IOP level.