Travoprost와 Tafluprost의 안압 및 안구박동 크기 변화에 대한 연구
Travoprost- and Tafluprost-induced Changes in Intraocular Pressure and Ocular Pulse Amplitude
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목적: 개방각녹내장 환자에서 travoprost 0.003%와 tafluprost 0.0015%를 장기 사용 후 안압하강 효과 및 안구박동 크기 변화에 대해 비교하고자 하였다. 대상과 방법: 2017년 1월부터 2019년 7월까지 본원에서 개방각녹내장으로 처음 진단된 환자들 대상으로 travoprost군 42안(23명), tafluprost군 26안(14명)을 비교하였다. 골드만압평안압계(Goldmann applanation tonometry, GAT)로 측정한 안압과 Dynamic Contour Tonometry로 측정한 corrected Ocular Pulse Amplitude (cOPA)를 1년 동안 경과 관찰하여 비교하였다. 결과: 1년간 travoprost와 tafluprost의 GAT, cOPA를 비교하였을 때 두 군 간 통계적으로 유의한 차이는 없었다(p=0.512, p=0.105). 초기 효과를 비교하였을 때 GAT의 변화량은 travoprost군이 -5.32 ± 2.63 mmHg, tafluprost군은 -3.79 ± 3.19 mmHg로 유의한 차이가 있었고(p=0.0457), cOPA는 travoprost군이 +0.04 ± 0.9 mmHg, tafluprost군이 -0.76 ± 0.97 mmHg로 유의한 차이를 보였다(p=0.0028). 결론: Travoprost와 tafluprost는 장기 안압하강 효과에 차이가 없으나 초기 효과에서는 travoprost가 더 빠르게 안압을 낮춰주었고, tafluprost가 OPA 변화에 더 많은 영향을 주었다. 상기 요인들을 고려하여 치료 목표에 따라 프로스타글란딘 제제를 선택할 수 있겠다.
Abstract
Purpose: To compare the intraocular pressure reduction and changes in ocular pulse amplitude of travoprost 0.003% and tafluprost 0.0015%. Methods: We assessed patients who were diagnosed with open-angle glaucoma from January 2017 to July 2019 for the first time at our hospital. Forty-two eyes were assigned to the travoprost group (23 patients) and 26 eyes were assigned to the tafluprost group (14 patients). Changes in intraocular pressure were measured by Goldmann applanation tonometry (GAT), and corrected ocular pulse amplitude (cOPA) was measured using dynamic contour tonometry. Changes in these parameters were observed and compared for 1 year. Results: No significant differences were observed between the GAT measurements and the cOPA of patients treated with travoprost and tafluprost for 1 year (p = 0.512, p = 0.105). The change in initial intraocular pressure on GAT observed after 1 week was -5.32 ± 2.63 mmHg for travoprost and -3.79 ± 3.19 mmHg for tafluprost (p = 0.0457). The initial change in cOPA was +0.04 ± 0.9 mmHg in the travoprost group and -0.76 ± 0.97 mmHg in the tafluprost group (p = 0.0028). Conclusions: Travoprost and tafluprost reached the targeted intraocular pressure with no difference in the long-term effects of reduced intraocular pressure. However, travoprost was initially better at lowering intraocular pressure faster, and tafluprost had a greater effect on lowering OPA. Prostaglandin analogs can be selected individually by considering the aforementioned factors.
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