Edoardo Villani1, Matteo Sacchi1, Fabrizio Magnani2, Angelo Nicodemo2, Susan E I Williams3, Alessandro Rossi2, Roberto Ratiglia2, Stefano De Cillà4, Paolo Nucci1. 1. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy 2Eye Clinic San Giuseppe Hospital, Milan, Italy. 2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy 3Fondazione IRCCS Ca' Granda Policlinico, Milan, Italy. 3. Division of Ophthalmology, Department of Neurosciences, University of the Witwatersrand, Johannesburg, South Africa. 4. Eye Clinic Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy 6Eye Clinic San Paolo Hospital, Milan, Italy.
Abstract
PURPOSE: To study clinical and in vivo laser scanning confocal microscopy (LSCM) ocular surface findings in stable, medically controlled primary open-angle glaucoma (MCPOAG) patients. METHODS: We recruited 100 consecutive patients with MCPOAG and 50 healthy controls. Patients had to have been treated with the same medical regimen without variation for the 18 months before enrollment and were excluded if there was a history of dry eye prior to glaucoma diagnosis. Each participant underwent ocular surface clinical and LSCM examination. RESULTS: In MCPOAG patients, subbasal nerve length and tortuosity and dendritic cell density were increased compared to controls (P < 0.01), but there were no clinical abnormalities. Patients treated with preserved drugs (n = 80) had reduced tear film breakup time (P < 0.05, ANOVA), and those preserved with benzalkonium chloride (n = 72) had reduced Schirmer test values (P < 0.001). Patients (n = 50) treated with two or more drugs had increased lissamine green conjunctival staining (P < 0.001, LSD post hoc test). Patients (n = 29) treated with three or more eye drops daily had decreased Schirmer test values. Laser scanning confocal microscopy showed subbasal changes related to preservatives, type and number of drugs, and number of eye drops. CONCLUSIONS: In stable MCPOAG patients without dry eye history, the ocular surface changes due to antiglaucoma medications are mostly subclinical. Active ingredients, preservatives, number of concomitant drugs, and number of eye drops instilled per day are all elements that can induce ocular surface changes. The clinical relevance of these changes remains to be determined.
PURPOSE: To study clinical and in vivo laser scanning confocal microscopy (LSCM) ocular surface findings in stable, medically controlled primary open-angle glaucoma (MCPOAG) patients. METHODS: We recruited 100 consecutive patients with MCPOAG and 50 healthy controls. Patients had to have been treated with the same medical regimen without variation for the 18 months before enrollment and were excluded if there was a history of dry eye prior to glaucoma diagnosis. Each participant underwent ocular surface clinical and LSCM examination. RESULTS: In MCPOAG patients, subbasal nerve length and tortuosity and dendritic cell density were increased compared to controls (P < 0.01), but there were no clinical abnormalities. Patients treated with preserved drugs (n = 80) had reduced tear film breakup time (P < 0.05, ANOVA), and those preserved with benzalkonium chloride (n = 72) had reduced Schirmer test values (P < 0.001). Patients (n = 50) treated with two or more drugs had increased lissamine green conjunctival staining (P < 0.001, LSD post hoc test). Patients (n = 29) treated with three or more eye drops daily had decreased Schirmer test values. Laser scanning confocal microscopy showed subbasal changes related to preservatives, type and number of drugs, and number of eye drops. CONCLUSIONS: In stable MCPOAG patients without dry eye history, the ocular surface changes due to antiglaucoma medications are mostly subclinical. Active ingredients, preservatives, number of concomitant drugs, and number of eye drops instilled per day are all elements that can induce ocular surface changes. The clinical relevance of these changes remains to be determined.
Authors: Silvio DI Staso; Luca Agnifili; Sara Cecannecchia; Angela DI Gregorio; Marco Ciancaglini Journal: In Vivo Date: 2018 Mar-Apr Impact factor: 2.155
Authors: Jose Maria Martinez-de-la-Casa; Carlos Oribio-Quinto; Almudena Milans-Del-Bosch; Pilar Perez-Garcia; Laura Morales-Fernandez; Javier Garcia-Bella; Jose Manuel Benitez-Del-Castillo; Julian Garcia-Feijoo; David P Piñero Journal: Eye Vis (Lond) Date: 2022-04-01