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使用硫酸阿托品鬆弛睫狀肌可能使眼壓升高嗎

使用硫酸阿托品鬆弛睫狀肌可能使眼壓升高嗎?沒點時,眼壓在二十左右,點了變二十四,五,醫生說點阿托品不會影響眼壓,可是我小孩已經試過幾次了,有點,沒點差四五左右,另外,因我本人有青光眼,是否因此我小孩較易誘發眼壓升高呢?煩請眼科醫師或藥師回答謝謝

2 Answers

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  • 力羊
    Lv 4
    1 decade ago
    Favorite Answer

    您好, Atropine不是不會影響"眼壓",正確的說法是: Atropine "不一定"會影響眼壓:請參考此份文件第八頁,在此我節錄第八頁所述並翻譯成中文給您:

    The largest single cause of glaucoma in these patients appears to be an atropine-like effect, eliciting pupillary dilatation. This class of agents includes antipsychotropics, antidepressants, the monoamine oxidase (MAO) inhibitors, antihistamines, antiparkinsonian agents, antispasmolytic agents, mydriatic agents, the sympathetic agents, and botulinum toxin.

    在”藥物引起型”青光眼病人中,最常見的就是像有使用atropine後誘發瞳孔放大的效果。 此類型的藥物包含”抗精神病用藥”,”抗憂鬱用藥”,”MAO inhibitor”(也是一種抗青光青用藥),”抗組織胺”,”抗巴金森氏正用藥”,”抗痙攣用藥”,”瞳孔放大用藥”,”交感神經用藥”與”肉毒桿菌”。

    The pupillary dilatation seen in these cases may be enough to precipitate an attack of angle-closure glaucoma in the patient with narrow,angles.

    上述這些例子中所造成的瞳孔放大足以造成加速原本眼前房隅角已經狹窄之病患造成”閉鎖型青光眼”(ACG)。

    With regard to open-angle glaucoma, the causes of elevated IOP are much more varied, including the release of pigment during the pupillary dilation with subsequent obstruction of the trabecular meshwork, and a possible increase of inflow during pupillary dilation.

    至於”開放型青光眼”,眼壓升高的原因有很多種,包括用藥後眼內的色素在瞳孔放大十被釋出且此色素造成隨之的隅角阻塞,並且這些色素在瞳孔放大時可能增加眼前房水的流出。

    如果很難理解,請跟眼科醫師溝通並進行Gonioscopy並評估前房隅角寬度,再來下定論是否會造成眼壓升高都還不嫌太早,如果您的眼科醫師還不習慣再處方藥物之前就先做Gonioscopy,那請照以下溝通:

    請幫我的孩子做一下Gonio(前房隅角鏡),看一下能否看到trabecular meshwork(抱歉這我不懂怎翻譯)。

    圖片參考:http://www.sarawakeyecare.com/Atlasofophthalmology...

    而上圖中你可以看到白色區域中有一條黑黑的帶狀,即為"trabecular meshwork",如果看不到,就代表此病患處方Atopine後很有可能造成IOP(眼壓)升高。

    希望有幫助到您,讓您能跟眼科醫師好好溝通。

    2009-09-03 06:11:59 補充:

    忘了提到: 有家族病史當然會提高其他家族成員患青光眼的機率。 如果確實以此case來看,只能很大膽臆測,您的雙眼皆為遠視所以造成ACG(隅角閉鎖型青光眼);雖有可能為近視,如為近視就是OAG(隅角開放型青光眼)。 因您提供的資料有限,在此做這種假設也只能如此大膽。

    Source(s): 自己-視光學士,視光學研究所碩士,並受過therapeutic training, 經驗
  • Anonymous
    7 years ago

    到下面的網址看看吧

    ▶▶http://qoozoo09260.pixnet.net/blog

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