Sinan BİLGİN, Esin BAŞER, Özcan Rasim KAYİKCİOĞLU

Göz içi basıncı yüksek glokom hastalarında başlangıç tedavisi olarak latanoprost ve dorzolamid/timolol fiks kombinasyon etkinliğinin değerlendirilmesi

Amaç: Önceden tedavi görmemiş olan yüksek basınçlı glokom olgularında başlangıç tedavisinde latanoprost ve dorzolamid/timolol sabit kombinasyonunun etkinliğinin değerlendirilmesi Yöntemler: Çalışmaya yeni tanı almış ve daha önce glokom tedavisi uygulanmamış, göz içi basıncı ölçümü 30 mmHg ve üzerinde olan 25 hasta dahil edildi. On altı gözde primer açık açılı glokom, 9 gözde psödoeksfoliasyon glokomu mevcuttu. Görme keskinliği, göz içi basıncı (GİB), bilgisayarlı görme alanı ölçümleri, iridokorneal açı ve optik sinir başını içeren oftalmolojik muayeneleri yapıldı. Hastalar tedavinin 1. ve 3.ayında GİB düşüşü ve yan etki profili açısından değerlendirildi. Bulgular: Başlangıç GİB değeri ortalama 38,4 ± 7 mmHg, 1. ay GİB değeri ortalama 16,3 ± 3,7 mmHg ve 3. ay GİB değeri ortalama 18,6 ± 4,2 mmHg olarak saptandı. Başlangıç GİB değerine göre 1. ayda 22,1 ± 9 mmHg (%55,7 ± 14,5), üçüncü ayda 19,8 ± 8,9 mmHg (%49,6 ± 15,9) düşüş sağlandı (p=0,0001). Hastaların hiçbirinde ciddi yan etki görülmedi. Beş (%20) hastada hafif hiperemi gözlenirken, iki (%8) hastada ağızda metalik tat şikayeti ile karşılaşıldı.Sonuç: Göz içi basıncı 30 mmHg'nın üzerindeki hastalarda başlangıç tedavisi olarak latanoprost ve dorzolamid/timolol sabit kombinasyonun erken dönemde oldukça etkili olduğunu ve yan etki profili açısından tolere edilebilir olduğunu söyleyebiliriz.

To evaluate the effectiveness of latanoprost and dorsolamide/timolol fixed combination therapy as initial treatment for glaucoma patients with high intraocular pressure

Objectives: To evaluate the effectiveness of latanoprost and dorsolamide-timolol fixed combination therapy as initial treatment for treatment naïve patients with intraocular pressure (IOP) values over 30 mm Hg.Methods: Twenty-five eyes of 25 newly diagnosed patients whose IOP measurements were at least 30 mmHg and who did not receive any antiglaucomatous medication previously were included in the study. Sixteen eyes had primary open angle glaucoma and 9 eyes had pseudoexfoliation glaucoma. Visual acuity, iridocorneal angle, intraocular pressure, optic nerve head and computerized visual field test were evaluated in each patient. Patients were evaluated on the first and third months of therapy for IOP reduction and ocular side effects.Results: The baseline average IOP was 38.4 ± 7.0 mmHg initially, at first month average IOP was 16.3± 3.7mmHg and at third month average IOP was 18.6 ± 4.2 mmHg. IOP reduction from baseline was 22.1 ± 9.0 mmHg (55.7± 14.5 %) for the first month, 19.8 ± 8.9 mmHg (49.6 ± 15.9 %) for the third month (p=0.0001) None of the patients reported any serious side-effects about therapy. Five (20%) had moderate hyperemia, 2 (8%) reported metallic taste.Conclusion: The combined therapy of latanoprost and dorsolamide/timolol fixed combination as initial treatment for intraocular pressure over 30 mmHg is highly efficient and well tolerated for treatment naive glaucoma.

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