青光眼的药物治疗.ppt

**SummaryLowIOPsslowthedevelopmentandprogressionofglaucoma.IndividualizedtargetIOPsshouldbesetbasedonpatientneeds.Patientswithmoreseverediseaseneedverylow(14mmHg)IOPstoprotectvision.ItisimportantthattargetIOPbemaintainedthroughoutthedayandnightandoverthelong-term.******ImportanceofMaintainingLow,StableIOPIOPineachindividualpatientfluctuatesduringthedayandnight.Typicallylowestduringthenightwithapeakearlyinthemorningorduringtheday.LargediurnalIOPfluctuationsareasignificantriskfactorfordiseaseprogression(Asranietal,2000).BecausedamagefromhighIOPisexponential,eventransientelevationsofIOPmaycausesignificantglaucomatousdamage.Patientswhohaveperiodicorsporadicpressurespikescanlosevisualfieldduetocumulativeeffects(Sampaolesietal,1968;Gonzalezetal,1996-1997;Asranietal,2000)Agoaloftherapy,therefore,shouldbetopreventtransientIOPelevationsandachievelow,stableIOP.ReferencesAsraniS,ZeimerR,WilenskyJ,etal.Largediurnalfluctuationsinintraocularpressureareanindependentriskfactorinpatientswithglaucoma.JGlaucoma.2000;9:134-142.DavidR,ZangwillL,BriscoeD.etal.Diurnalintraocularpressurevariations:ananalysisof690diurnalcurves.BrJOphthalmol.1992,76(5):280-283.SampaolesiR,CalixtoN,CarvalhoCA,RecaR.Diurnalvariationofintraocularpressureinhealthy,suspectedandglaucomatouseyes.ModProblOphthalmol.1968;6:1-23.GonzalezI,PabloPE,PueyoM,etal.Assessmentofdiurnaltensionalcurveinearlyglaucomadamage.IntOphthalmol.1996-97;20:113-115.******DiurnalIOPFluctuationsandGlaucomatousProgressionThisgraphdemonstratesthatglaucomapatientswithwidediurnalIOPfluctuationsareatgreaterriskofvisualfieldlossthanthosewithmorestableIOPlevelsthroughouttheday.ThesingleIOPmeasurestakenintheclinicdidnotpredicttheextent