**2.1 Subjects**

Subjects were patients with asthenopia in Kyoto Prefectural University of Medicine facilities in 2012~2014. We selected patients who had asthenopia symptoms, regardless of causes such as dry eye or inappropriate glasses. Subjects were 40 patients (35 females and 5 males), and 25~87 years old (average age: 62.5 years old).

## **2.2 Methods**

Two or three times per day, subjects ingested Adetphos Kowa Granule 10% which is clinical medicine containing 100 mg of ATP-2Na. Before and after 1 and 3


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*Clinical Evaluation of Adenosine Triphosphate Disodium Hydrate (ATP-2Na) for Asthenopia*

months ingestion, subjects completed a questionnaire to determine their asthenopia symptom and fatigue symptom by visual analog scale (VAS) [8] (**Table 1**). In VAS scale, 0 is the best evaluated result and 10 is the worst evaluated result. Questionnaire items were 10 items; 5 items about eye symptoms (feeling of oppression of the eyes, pain in the back of the eyes, tough to open eyes, blurred vision, sense of heat of eyes), 3 items about systemic symptoms (headache, stiff shoulder, fatigue), and 2 items about mental symptoms (depressed feeling, no concentration feeling). The scores were compared between before and after

In addition, the scores were compared about the background factors before administration. Researched background factors were gender, age, internal dose per body weight, whether or not other eye diseases, whether or not of using eye drop for asthenopia, and scores before ingestion. Within this study, subjects continued

Paired t test was used to compare the change of scores between before and after ingestion. In analysis of background factors, student's t test was used the changes through 3 months. In both analysis, p < 0.05 was considered statistically

In 40 initial subjects, 33 subjects visited hospital at 1 month, and these subjects were targeted for evaluation of safety. In 33 subjects, one subject discontinued the ingestion because of diarrhea within 1 month, one refused to describe the questionnaire. 31 subjects completed a questionnaire for 1 month and were targeted for effect evaluation. Age distribution of 31 subjects (26 females, 5 males) was 25–87 years old, average age was 64.4 years old. Background factors are presented in **Table 2**. Average score of eye symptom in group with diabetes was larger than that in group without diabetes (p < 0.01). Average score of systemic symptom in group 65y younger was larger than that in group 65y older (p < 0.05). 26 subjects

The scores about eye symptom before ingestion, 1 month, 3 months were 4.05 ± 3.22, 2.67 ± 2.19, and 2.41 ± 2.16, respectively. The scores were significantly decreased at 1 and 3 months (both p < 0.005, **Figure 1**). Among the symptoms about eye, the scores of "blurred vision" were no different between before and after (**Figure 2**). The scores about systemic symptom (average scores; before ingestion: 4.76 ± 3.05, 1 month: 3.08 ± 2.93, and 3 months: 3.13 ± 3.18) significantly decreased (p < 0.005). Similarly, the scores about mental symptom (average scores; before ingestion: 4.41 ± 3.46, 1 month: 2.97 ± 2.63, and 3 months: 3.10 ± 3.19) significantly

*DOI: http://dx.doi.org/10.5772/intechopen.80288*

all drugs prescribed before the administration.

ingestion.

significant.

**3. Results**

**2.3 Statistical analysis**

**3.1 Subject characteristics**

**3.2 Effect evaluations**

decreased (p < 0.005).

*3.2.1 Scores in each symptom*

completed a questionnaire for 3 months.
