{"id":7892,"date":"2018-11-17T08:58:55","date_gmt":"2018-11-17T13:58:55","guid":{"rendered":"https:\/\/themedicalxchange.com\/?p=7892"},"modified":"2021-07-20T10:02:34","modified_gmt":"2021-07-20T14:02:34","slug":"aao_7019_options-therapeutiques-en-vue-pour-la-prise-en-charge-du-glaucome","status":"publish","type":"post","link":"https:\/\/themedicalxchange.com\/fr\/2018\/11\/17\/aao_7019_options-therapeutiques-en-vue-pour-la-prise-en-charge-du-glaucome\/","title":{"rendered":"Options th\u00e9rapeutiques en vue pour la prise en charge du glaucome"},"content":{"rendered":"

Contrer l\u2019inobservance du traitement par les patients<\/h2>\n

Selon des statistiques tir\u00e9es d\u2019une \u00e9tude am\u00e9ricaine, pr\u00e8s de la moiti\u00e9 des patients ayant fait ex\u00e9cuter une ordonnance de m\u00e9dicament anti-glaucome ont abandonn\u00e9 le traitement m\u00e9dical dans les 6 mois suivants, et \u00e0 peine plus du tiers (37 %) avaient renouvel\u00e9 l\u2019ordonnance de leur m\u00e9dicament initial 3 ans apr\u00e8s l\u2019avoir fait ex\u00e9cuter la premi\u00e8re fois (Nordstrom BL et al., Am J Ophthalmol.<\/em> 2005;140:598-606). Point \u00e0 noter, les patients avaient plus tendance \u00e0 observer le traitement s\u2019ils \u00e9taient atteints d\u2019un glaucome \u00e0 angle ouvert confirm\u00e9 que s\u2019ils avaient un glaucome pr\u00e9sum\u00e9. Par ailleurs, malgr\u00e9 les taux d\u2019observance diff\u00e9rents pour les 4 classes de m\u00e9dicaments \u00e9valu\u00e9es, ces r\u00e9sultats montrent qu\u2019il est effectivement possible de faire mieux.<\/p>\n

Dans le cadre du volet glaucome de la journ\u00e9e des sous-sp\u00e9cialit\u00e9s au congr\u00e8s annuel 2018 de l\u2019American Academy of Ophthalmology (AAO), le Dr<\/sup> James D. Brandt, professeur d\u2019ophtalmologie et des sciences de la vision et directeur du service du glaucome \u00e0 l\u2019Universit\u00e9 de la Californie, \u00e0 Davis, en Californie, a pr\u00e9sent\u00e9 quelques exemples de dispositifs \u00e0 l\u2019\u00e9tude qui pourraient offrir des options de rechange dans la ma\u00eetrise de la PIO.\u00a0<\/p>\n

\u00ab Nous avons un important paradoxe de traitement, a dit le Dr<\/sup>\u00a0Brandt. Nous disposons de traitements tr\u00e8s efficaces qui fonctionnent (collyres), mais nous savons que jusqu\u2019\u00e0 50 % de nos patients n\u2019instillent pas leurs gouttes. De plus, nous pouvons difficilement d\u00e9terminer qui observe son traitement et qui ne l\u2019observe pas. L\u2019administration de m\u00e9dicaments \u00e0 lib\u00e9ration prolong\u00e9e nous aidera \u00e0 r\u00e9soudre ce probl\u00e8me. Elle pourrait permettre une ma\u00eetrise \u00e0 long terme de la PIO sans instillation quotidienne \u00bb (Fig. 1<\/a>).<\/p>\n

Surveillance \u00e0 domicile de la PIO<\/h2>\n

Le Dr<\/sup>\u00a0Brandt est d\u2019avis que la surveillance \u00e0 domicile de la PIO sera un \u00e9l\u00e9ment essentiel des soins contre le glaucome si les m\u00e9dicaments \u00e0 lib\u00e9ration prolong\u00e9e sont offerts. \u00ab La tonom\u00e9trie \u00e0 domicile fera partie int\u00e9grante de l\u2019acceptation des (traitements) \u00e0 lib\u00e9ration prolong\u00e9e, dit-il, soulignant qu\u2019aucun sympt\u00f4me ne survient pour indiquer aux patients que leur PIO augmente et qu\u2019ils ont besoin d\u2019\u00eatre trait\u00e9s.<\/p>\n

\u00ab \u00c0 l\u2019heure actuelle, nous avons seulement des mesures ponctuelles de la PIO \u00e0 la clinique, estime le Dr<\/sup>\u00a0Patrick Gooi, directeur de la sous-section glaucome \u00e0 l\u2019Universit\u00e9 de Calgary, en Alberta. La PIO fluctue sur 24 heures. La gestion des donn\u00e9es de tonom\u00e9trie \u00e0 domicile sera importante, afin que des donn\u00e9es fiables puissent \u00eatre recueillies et transmises aux m\u00e9decins d\u2019une mani\u00e8re s\u00fbre et pertinente. \u00bb\u00a0<\/p>\n

\n
\u00ab Si l\u2019on constate que la PIO fluctue plus que ce que les visites cliniques laissent supposer, il pourrait y avoir lieu d\u2019intensifier le traitement par des collyres, un laser ou une intervention chirurgicale. \u00bb<\/div>\n<\/blockquote>\n
\n
Les donn\u00e9es qui seraient g\u00e9n\u00e9r\u00e9es par les technologies de tonom\u00e9trie \u00e0 domicile pourraient guider les choix de traitement. \u00ab Si l\u2019on constate que la PIO fluctue plus que ce que les visites cliniques laissent supposer, il pourrait y avoir lieu d\u2019intensifier le traitement par des collyres, un laser ou une intervention chirurgicale \u00bb, ajoute le Dr<\/sup>\u00a0Gooi.<\/div>\n

Conclusion<\/h2>\n

Un nombre accru d\u2019options th\u00e9rapeutiques et une meilleure surveillance de la PIO permettraient aux cliniciens d\u2019\u00e9laborer des plans de prise en charge plus \u00e9clair\u00e9s et plus individualis\u00e9s pour leurs patients atteints de glaucome.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Chicago<\/b> \u2013 L\u2019observance du traitement m\u00e9dical chez les patients atteints de glaucome est sous-optimale. Pour rem\u00e9dier au probl\u00e8me, des chercheurs explorent d\u2019autres strat\u00e9gies d\u2019administration des traitements m\u00e9dicaux. Afin que les plateformes de lib\u00e9ration prolong\u00e9e soient viables, une surveillance \u00e0 domicile de la pression intraoculaire (PIO) deviendra probablement un \u00e9l\u00e9ment de la prise en charge globale du glaucome.<\/p>\n","protected":false},"author":9,"featured_media":7900,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"tags":[522,525,523,491],"class_list":["post-7892","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","tag-2018-fr","tag-aao-fr","tag-extract-fr","tag-ophtalmologie","area_tag-ophtalmologie"],"acf":[],"yoast_head":"\nOptions th\u00e9rapeutiques en vue pour la prise en charge du glaucome - The Medical Xchange<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/themedicalxchange.com\/fr\/2018\/11\/17\/aao_7019_options-therapeutiques-en-vue-pour-la-prise-en-charge-du-glaucome\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Options th\u00e9rapeutiques en vue pour la prise en charge du glaucome - The Medical Xchange\" \/>\n<meta property=\"og:description\" content=\"Chicago \u2013 L\u2019observance du traitement m\u00e9dical chez les patients atteints de glaucome est sous-optimale. 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