Evaluation Of Efficacy And Quality Of Life Of Topical Intraocul Ar Pressure Lowering Drugs In Patients With POAG And OH

Background and purpose:The main means for the treatment of glaucoma and the ultimate goal is still to reduce intraocular pressure,intraocular pressure(IOP)as the exact risk factors can be controlled.Topical antiglaucoma medication,is still the main means of glaucoma patients.The topical intraocular pressure lowering drugs: prostaglandins(prostaglandin analogues called,PGA)eye drops is primary open angle glaucoma(primary open angle glaucoma,POAG patients first-line medicines [1],at present clinical commonly used PGA single agents have bimatoprost,travoprost and latanoprost.The mechanism of reducing intraocular pressure by PGA eye drug water is mainly through the increase of the aqueous humor of the uveoscleral pathway[2,3],so as to prevents further damage to the optic nerve.However,no matter what the local hypotensive drugs on ocular surface can cause a certain impact,this is mainly related to the role of the drug itself,the preservative,drug dosage,frequency of use,and so on.Reported in the literature on the PGA is leading to the parameters of anterior segment of central corneal thickness(central corneal thickness,CCT)become thin(or change)hold different opinions,and central corneal thickness changes on intraocular pressure(IOP)whether effects are still controversial.Intraocular pressure(IOP)as common indicators can be measured,is one of the basic indicators of the diagnosis and treatment of patients with glaucoma,satisfactory control of intraocular pressure can be maintained in the majority of patients with glaucoma visual function.Intraocular pressure measurement instruments is numerous,the Goldmann tonometer and non-contact tonometer is commonly used in the clinic;however,there are some limitations.With the introduction of new tonometer Corvis@ST,with its convenient,fast,and has good repeatability,etc.are gradually applied in clinical.However,it has not been obvious reported that whether the patients with glaucoma and ocular hypertension have good clinical use value.The treatment of glaucoma and ocular hypertension patients to reduce intraocular pressure,prevent the further decline of visual function,but to maintain the quality of life of patients(quality of life,QOL)is the ultimate goal of treatment.Therefore,whether the effect can be observed through the changes of intraocular pressure in patients with glaucoma topical drugs(antihypertensive effect and side effect)as well as long-term survival quality of patients,comprehensive analysis of glaucoma and ocular hypertension patients in local use different intraocular pressure lowering drug treatment effect,ocular surface health status and analysis of factors affect the quality of life of patients,for clinical rational,providing scientific basis for personalized use of hypotensive drugs and follow-up of glaucoma,so as to improve the the treatment effect and quality of life.In view of the above research background,the main purpose of this study is: for clinical diagnosis of primary open angle glaucoma and ocular hypertension disease and accept the topical intraocular pressure lowering drug treatment of patients,choose new tonometer Corvis@ST whether measurement of intraocular pressure in such patients has clinical significance;and observe the long-term after administration of the ocular surface health and ocular surface structure effects and through the questionnaire survey table on the patient's quality of life were analyzed and summarized,combined with the eyes in the daily life of the patients at the same time as can reflect the patients of visual function in eyes visual field assessment,simulation of binocular vision to integrate(integrated visual field,IVF)[4] and so on.Methods: 163 cases of outpatient primary open-angle glaucoma and ocular hypertension patients were improved: ocular surface tear break-up time(BUT),corneal fluorescein staining(FL),dry eye questionnaire,ocular surface score and quality of life scale and other related inspection;one in 131 newly diagnosed patients.Three tonometers: Goldmann,non-contact tonometer and Corvis@ST tonometer(NCT)and the central corneal thickness measurement: A,Pentacam,observe the Corvis@ST parameter measurement repeatability and three tonometer consistency;the simple use of the Travoprost Eye Drops 0.004%(71 eyes)and 0.15% Brimonidine Tartrate Opthealmic Solution(48 eyes)patients were: A,Pentacam,Corvis@ examination,and the central corneal thickness and corneal thickness and IOP correction around 6 months of follow-up.Result:1.The repeatability of the Corvis@st measurements of corneal biomechanical parameters better,the parameters p were > 0.05;three kinds of intraocular pressure meter measuring intraocular pressure values are different,with the change of CCT and measurement of IOPst value amplitude is not obvious,and IOPnct,IOPg changes in the amplitude of the larger three kinds of intraocular pressure(IOP)meter according to the CCT adjusted IOP value differences were not statistically significant(P < 0.05).2.After 6 months,0.004% Travoprost Eye Drops group(group Tra)in CCT,Apex CT,TCT,CT2,CT4,CT6,,CT8 were all similar to the thinning trend before treatment(P < 0.05);the medication 3 months CCT are prodrugs average variable thin(4.63 + 0.62)m,6 months average thinning(5.67 + 0.64)m;medication before c-IOP differences with medication for 3 and 6 months had no statistical significance.0.15% tartaric acid bromine brimonidine eyedrops group(BRI)group followed up 3 months,6 months after the corneal thickness and c-IOP differences in the had no statistical significance(P > 0.05).3.Regression analysis of 163 cases of patients with ocular surface score and age,tear break-up time(but),drug use quantity,duration,and some medicine related(P < 0.05),correlation coefficient were 0.846,-0.729,0.226,0.204,0.176;dry eye risk factors: gender,age,frequency of administration,duration,tear break-up time(but),drug use quantity.4.163 patients quality of life(QOL)table GQL-15 and binocular integration VFI and ocular scale scores were significantly correlated(P < 0.01).The correlation coefficient reached-0.843,0.627,and with economic level,education level correlation coefficient is:-0.312,-0.215.Conclusions:1.Intraocular pressure as the only factor that can be controlled,this study found that Corvis@ST is safe and effective for patients with open angle glaucoma and ocular hypertension,and can be used as one of the long-term follow-up of patients.2.After 6 months of follow-up,the patients who were treated with topical prostaglandin eye drops were observed and found to have a tendency to become thinner.3.For local and long-term use of drugs to lower intraocular pressure(IOP)in the treatment of original primary open angle glaucoma and ocular hypertension patients,on the surface of the eye health resulting in dry eye,that the cause of dry eye risk factors: patient's age,type of drug,quantity,time,frequency,etc.4.Patients' quality of life was significantly related to the ocular surface health,the VFI value of binocular integration,and the economic level,educational level,and so on.