정상안압녹내장 환자에서 타플루프로스트 0.0015%와티몰롤 0.5% 혼합제제의 효과
The Effect of a Fixed Combination of 0.0015% Tafluprost-0.5% Timolol in Normal Tension Glaucoma Patients
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목적: 정상안압녹내장 환자에서 tafluporst 0.0015%와 timolol 0.5% 혼합제제(Tapcom®, Santen, Osaka, Japan)의 안압하강 효과에 대해 알아보고자 한다. 대상과 방법: Tafluprost 0.0015%와 timolol 0.5% 혼합제제를 사용하고 있는 정상안압녹내장 환자 23명을 대상으로 혼합제제를 사용하기 전 오전 9시부터 오후 4시 30분까지 2시간 30분 간격으로 하루 안압을 측정하고, 오후 4시 30분에 자세별 안압을 측정하였으며, 혼합제제를 6개월간 사용한 후 하루 안압 및 자세별 안압을 다시 측정하여 안압하강 효과에 대해 분석하였다. 결과: 6개월간 tafluprost 0.0015%-timolol 0.5% 혼합제제 점안 후 안압하강 효과는 우안 -3.37 ± 2.39 mmHg (-19.70 ± 13.97%), 좌안 -3.22 ± 2.27 mmHg (-18.81 ± 13.28%)로 통계적으로 유의한 감소를 보였으며, 오후 4시 30분에 측정한 자세별 안압에서 치료전과 비교하여 양안 모두 통계적으로 유의한 하강을 보였다. 점안안에서 하루 안압의 변동 양상은 변동량이 3 mmHg 이하인 군의비율이 6개월간 혼합제제 점안 후 통계적으로 유의하게 증가하였으며, 안압하강 효과는 혼합제제 점안 후 처음 1개월 동안 가장 크게 나타났고, 안과적 손상을 유발할 만한 심각한 부작용은 나타나지 않았다. 결론: 녹내장 환자에서 tafluprost 0.0015%-timolol 0.5% 혼합제제는 안전하며 안압을 하강시키고, 안정적으로 유지시키는 데 효과적이다.
Abstract
Purpose: This study evaluated the effect of a fixed combination of 0.0015% tafluprost-0.5% timolol (Tapcom®, Santen, Osaka, Japan) in glaucoma patients. Methods: This study included 23 patients who were diagnosed with normal tension glaucoma and treated with a fixed combination of 0.0015% tafluprost-0.5% timolol as the first therapy. Diurnal intraocular pressure (IOP) was measured every 2 and 0.5 hours between 9:00 am and 4:30 pm. The IOP change with respect to body position (positional IOP) was measured at baseline and at 6 months after eye-drop instillations. IOP fluctuation was defined as the standard deviation of IOP measurements. Throughout the study, all side effects were recorded and monitored by the investigators. Results: The mean reduction in IOP in the 0.0015% tafluprost-0.5% timolol fixed combination-treated eyes was -3.37 ± 2.39 mmHg (-19.70 ± 13.97%) for the right eye and -3.22 ± 2.27 mmHg (-18.81 ± 13.28%) for the left eye (paired t-test, p < 0.001). The mean positional IOP measured at 4 pm at 6 months after 0.0015% tafluprost-0.5% timolol fixed combination instillation showed statistically significant reduction from the mean positional IOP at baseline. There was a significant difference in the number of patients with ≤3 mmHg IOP variation over four time points between baseline and at 6 months in the 0.0015% tafluprost-0.5% timolol fixed combination-treated eyes (McNemar test, p < 0.001). There was no serious adverse event causing ocular damage. Conclusions: Use of 0.0015% tafluprost-0.5% timolol fixed combination was effective and well tolerated in reducing IOP and in maintaining its effectiveness in glaucoma patients.
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