경도에서 중등도의 안구건조증을 가진 정상안압녹내장에서 무보존제 라타노프로스트의 임상효과 = Efficacy of Preservative-free Latanoprost in Normal-tension Glaucoma with Mild to Moderate Dry Eye

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the efficacy and safety of preservative-free latanoprost in patients with normal-tension glaucoma who had mild to moderate dry eye after switching from preserved latanoprost.
Methods: This retrospective study was conducted in patients with normal-tension glaucoma who had mild to moderate dry eye.
All enrolled patients had used preserved latanoprost and switched to preservative-free Latanoprost. The study consisted of a baseline visit (treatment with preserved latanoprost) and four follow-up visits conducted after 1, 3, 6, and 12 months of treatment with preservative-free latanoprost. Intraocular pressure (IOP), mean deviation (MD), ocular surface disease index (OSDI), Shirmer’s test score, tear break-up time (TBUT), corneo-conjunctival fluorescein staining, and adverse drug reactions were evaluated.
Results: The mean IOP and MD values during treatment with preserved latanoprost were 14.1 ± 2.6 mmHg and -2.68 ± 0.11 dB, respectively. The mean IOP and MD values at 12 months after switching to preservative-free latanoprost were 13.9 ± 1.9 mmHg and -2.66 ± 0.12 dB, respectively. The OSDI, Shirmer’s test score, BUT, and corneo-conjunctival fluorescein staining during treatment with preserved latanoprost were 53.15 ± 8.86, 4.97 ± 1.71 mm, 4.92 ± 1.72 seconds, and 2.92 ± 1.05, respectively. The OSDI, Shirmer’s test score, TBUT, and corneo-conjunctival fluorescein staining at 12 months after switching to preservative-free latanoprost were 49.07 ± 6.97, 5.51 ± 1.48 mm, 5.49 ± 1.46 seconds, and 2.47 ± 1.09, respectively. There were no serious adverse drug reactions causing ocular damage.
Conclusions: Preservative-free latanoprost was effective for improving objective and subjective symptoms compared to preserved latanoprost; it maintained a stable IOP and visual field value in patients with normal-tension glaucoma who had mild to moderate dry eye.

국문 초록 (Abstract)

목적: 경도에서 중등도의 안구건조증을 가진 정상안압녹내장 환자에서 보존제가 포함된 라타노프로스트 제제에서 무보존제 제제로 변경 시 임상 효과에 대해서 알아보고자 하였다.
대상과 방법: 경도에서 중등도의 안구건조증을 가진 정상안압녹내장 환자 중 보존제가 포함된 라타노프로스트 제제에서 무보존제 제제로 변경한 환자를 대상으로 의무기록을 후향적으로 분석하였다. 약제 변경 전과 변경 후 1개월, 3개월, 6개월, 그리고 12개월째 안압, mean deviation (MD), Ocular Surface Disease Index (OSDI) 점수, 쉬르머 I 검사, 눈물막파괴시간, 그리고 각막 및 결막염색지수를 비교 분석하였다.
결과: 보존제가 포함된 라타노프로스트를 사용한 경우 안압과 MD값은 각각 14.1 ± 2.6 mmHg, -2.68 ± 0.11 dB이었고, 무보존제로 변경 후 12개월째 안압과 MD값은 각각 13.9 ± 1.9 mmHg, -2.66 ± 0.12 dB로 보존제가 포함된 라타노프로스트를 사용한 경우와 비교하여 통계적으로 유의한 차이가 없었다. 또한 약제 변경 전 OSDI 점수, 쉬르머 I 검사, 눈물막파괴시간, 그리고 각막 및 결막 염색지수 결과는 각각 53.15 ± 8.86, 4.97 ± 1.71 mm, 4.92 ± 1.72초, 그리고 2.92 ± 1.05였고, 약제 변경 후 12개월째 OSDI 점수, 쉬르머I 검사, 눈물막파괴시간, 그리고 각막 및 결막 염색 지수 결과는 각각 49.07 ± 6.97, 5.51 ± 1.48 mm, 5.49 ± 1.46초, 그리고 2.47 ± 1.09로 약제 변경 전과 비교하여 유의하게 호전된 결과를 보였다. 약제를 중단할 만한 심각한 부작용은 발생하지 않았다.
결론: 보존제가 포함된 라타노프로스트 제제를 사용 중인 안구건조증을 가진 정상안압녹내장에서 무보존제 제제로 변경할 경우, 보존제가 포함된 제제와 비교하여 동등한 안압하강 효과와 시야 결손 진행 억제 효과를 보였고 안구표면 질환의 유의한 개선 효과를 보였다.

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