Uso de drogas antiglaucomatosas em pacientes com glaucoma severo: quantas são necessarias para controle da doenca? / Use of antiglaucomatous drugs in patients with severe glaucoma: how many are necessary to control the disease?

RESUMO

Resumo Introdução: O glaucoma e a principal causa de cegueira irreversivel no Brasil. Ate o momento nao se dispoe de uma droga ideal para o controle da pressao intraocular (PIO), geralmente necessitando associar dois ou mais medicamentos hipotensores, com frequentes instilacoes diarias e ma aderencia ao tratamento. Objetivos: Descrever quantitativa e qualitativamente as drogas usadas para controle da PIO e a eficacia do tratamento na prevencao da cegueira. Métodos: Estudo transversal retrospectivo, atraves de revisao de 420 prontuarios de portadores de Glaucoma severo acompanhados no ambulatorio do Hospital Emilio Carlos, de Catanduva-SP, de janeiro/2014 a dezembro/2016. As variaveis analisadas foram idade, acuidade visual e medicamentos antiglaucomatosos utilizados topicos (colirios) e sistemicos. Resultados: A media de idade dos participantes foi 62,99±16,29 anos. Foram detectados 68 casos de cegueira, sendo que 3 pacientes (0,7%)perderam a visao no tempo investigado, com referencias a periodos sem tratamento/subdose/instilacao indevida/uso de 3 ou 4 colirios. Em 73,3% dos casos conseguiu-se estabilizacao da PIO com o uso de um (38,1%) ou no maximo 02 (35,2%) colirios associados. Houve correlacao significativa entre o no de combinacoes de hipotensores topicos e o no de pacientes em uso de Acetazolamida. O medicamentomais usado foi o Maleato de Timolol (67,1%). Conclusões: Na maioria dos pacientes a PIO foi controlada com 1 ou 2 colirios associados; pequena porcentagem dos casos evoluiu para cegueira; muito provavelmente a evolucao para perda de visao foi decorrente da complexidade e ma aderencia ao tratamento.

ABSTRACT

ABSTRACT Introduction: Glaucoma is the main cause of irreversible blindness in Brazil. To date, there is no ideal drug for the control of intraocular pressure (IOP), usually requiring the combination of two or more hypotensive drugs, with frequent daily instillations and poor adherence to treatment. Objectives: To describe quantitatively and qualitatively the drugs used to control IOP and the efficacy of treatment in the prevention of blindness. Methods: A retrospective cross-sectional study was carried out through a review of 420 medical records of patients with severe Glaucoma who were followed up at the Emílio Carlos Hospital outpatient clinic in Catanduva, SP, from January 2014 to December 2016. The analyzed variables were age, visual acuity and antiglaucomatous drugs used topical (eye drops) and systemic. Results:The mean age of participants was 62.99 ± 16.29 years. Sixty-eight cases of blindness were detected, and three patients (0.7%) lost vision at the time investigated, with references to periods without treatment / subdose / improper instillation / use of 3 or 4 eye drops. In 73.3% of the cases, IOP stabilization was achieved with one (38.1%) or at most 02 (35.2%) associated drops. There was a significant correlation between the number of combinations of topical hypotensive agents and the number of patients taking acetazolamide. The drugmostused was Timolol (67.1%). Conclusions: In the majority of patients IOP was controlled with 1 or 2 associated eye drops; small percentage of cases evolved into blindness; most likely the evolution to loss of vision was due to the complexity and poor adherence to the treatment.