多剤使用時におけるラタノプロストへのウノプロストンの併用効果

Hypotensive effect of unoprostone as adjunct to latanoprost during multiple drug therapy for glaucoma

　目的：ラタノプロストを含む多剤療法でのウノプロストン0.012％の併用効果の検討。方法：3か月以上，チモロール0.5％，ラタノプロスト0.005％，ドルゾラミド1％を点眼している原発開放隅角緑内障50名50眼につき，25眼にはウノプロストンを追加し，ほかの25眼は追加せず対照群とした。以後8週間，眼圧，自覚症状，他覚所見を観察した。結果：追加前の眼圧はウノプロストン群が19.4±2.5mmHg，対照群が19.6±2.4mmHgであり，両群間に有意差はなかった。8週後の眼圧はウノプロストン群が19.1±1.9mmHg，対照群が19.6±2.4mmHgで，経過観察開始後のいずれの時期でも追加前の眼圧と有意差がなかった。眼圧が22mmHg以上の17眼では，8週後にウノプロストン群8眼での眼圧が1.3±1.1mmHg下降した。この値は，対照群9眼での0.1±1.0mmHg下降に比べ有意に大きかった（p＝0.0324）。眼圧が21mmHg以下の33眼では，両群間に有意な差はなかった。結論：ラタノプロストを含む多剤療法でのウノプロストン点眼追加により，有意な眼圧変化は起こらず，追加前の眼圧が22mmHg以上の症例にのみ有意な眼圧下降が起こった。

　Purpose：To evaluate the hypotensive effect of 0.012％unoprostone when added to latanoprost in multiple drug treatment. Methods：Fifty eyes of 50 patients with primary open-angle glaucoma were enrolled in the study. They had been receiving 0.5％timolol,0.005％latanoprost and 1％dorzolamide for 3months or longer. They were randomly divided into two groups of 25 eyes each. One group received unoprostone adjunctively. The other group continued the medication without unoprostone and served as control. Results：Baseline intraocular pressure（IOP）averaged 19.4±2.5mmHg in unoprostone group and 19.6±2.4mmHg in control group. There was no significant difference between the two values. Eight weeks after start of unoprostone,the IOP averaged 19.1±1.9mmHg in unoprostone group and 19.6±2.4mmHg in control group. There was no significant difference in IOP between both groups up to 8 weeks. In 17 eyes with baseline IOP of 22mmHg or over,the IOP decreased 8 weeks later by 1.3±1.0mmHg in 8 eyes receiving unoprostone and by 0.1±1.0mmHg in 9 control eyes. The difference was significant（p＝0.0324）．There was no difference in IOP in 33 eyes with baseline IOP of 21mmHg or less. Conclusion：Addition of unoprostone did not induce further ocular hypotension when seen as a whole. Only when the baseline IOP was 22mmHg or over,additional unoprostone induced significant IOP reduction.