Intraocular pressure-lowering effects of ripasudil, a rho-kinase inhibitor, and selective laser trabeculoplasty as adjuv
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ORIGINAL PAPER
Intraocular pressure-lowering effects of ripasudil, a rhokinase inhibitor, and selective laser trabeculoplasty as adjuvant therapy in patients with uncontrolled glaucoma Koichi Ono
. Fumika Sakemi . Tatsuya Marumoto
Received: 10 June 2020 / Accepted: 2 October 2020 Ó Springer Nature B.V. 2020
Abstract Objectives To compare the intraocular pressure (IOP)-lowering effects of ripasudil, a rho-kinase inhibitor, and selective laser trabeculoplasty (SLT) as adjuvant therapy in Japanese glaucoma patients and to identify the factors associated with treatment success. Methods We performed a retrospective medical chart review of patients with glaucoma who received ripasudil or SLT as an adjuvant therapy. We collected data on 65 eyes (65 patients) with primary open-angle glaucoma, normal-tension glaucoma, or exfoliation glaucoma with at least 12 months of follow-up. IOP and number of glaucoma medications at 0, 1, 3, 6, 9, and 12 months were compared between and within groups. A repeated-measures mixed model was used to perform statistical analysis. We also investigated factors associated with treatment success, which was defined as C 20% reduction in IOP at all follow-up periods, using univariate and multivariate logistic regression analysis.
Results Significant IOP reduction was observed at all time-points after treatment in the ripasudil group (n = 33) and in the SLT group (n = 32), with no statistically significant difference between the groups before or after treatment. Patients in the SLT group used more anti-glaucoma medications before treatment, but fewer during follow-up, than those in the ripasudil group. Regardless of treatment, higher baseline IOP was associated with treatment success [crude odds ratio: 1.21 (95% confidence interval: 1.06–1.38), adjusted odds ratio: 1.37 (95% confidence interval: 1.06–1.77)]. Conclusions Adjuvant SLT or ripasudil in patients with inadequately controlled glaucoma both reduced IOP to a similar degree, but SLT contributed to reducing the number of medications used. Keywords Glaucoma A rho-kinase inhibitor Selective laser trabeculoplasty Intraocular pressure
Background K. Ono (&) F. Sakemi Department of Ophthalmology, Juntendo Tokyo-Koto Geriatric Medical Center, Juntendo University School of Medicine, Shinsuna 3-3-20, Koto-ku, Tokyo 136-0075, Japan e-mail: [email protected] T. Marumoto Marumoto Eye Clinic, Yokohama, Kanagawa, Japan
Glaucoma is the third leading cause of blindness and distance visual impairment worldwide, after refractive errors and cataracts [1], and the leading contributor to newly certified visual impairments in Japan [2]. Owing to a super-aging society, the number of glaucoma patients is expected to increase
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Int Ophthalmol
substantially. According to a population-based survey in Japan [3, 4], primary open-angle glaucoma (POAG) is the most common type of glaucoma. Elevated intraocular pressure (IOP) due to impaired aqueous humor outflow is strongly associated with the onset and pr
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