Ocular Surface Disease in Patients under Topical Treatment for Glaucoma

2017 ◽  
Vol 27 (6) ◽  
pp. 694-704 ◽  
Author(s):  
Francisco Pérez-Bartolomé ◽  
Jose M. Martínez-de-la-Casa ◽  
Pedro Arriola-Villalobos ◽  
Cristina Fernández-Pérez ◽  
Vicente Polo ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Treatment Duration ◽  
Open Angle Glaucoma ◽  
Tear Film ◽  
Older Age ◽  
Ocular Surface Disease ◽  
Medication Group ◽  
Pressure Lowering ◽  
Tear Meniscus Height ◽  
Corneal Staining

Purpose To examine the relationship between ocular surface disease (OSD) and topical antiglaucoma therapy. Methods A total of 211 eyes of 211 patients with open-angle glaucoma or ocular hypertension on topical medication were recruited over 10 months. Controls were 51 eyes of 51 healthy age- and sex-matched volunteers. In each patient, we recorded the intraocular pressure-lowering eyedrops used, the number of medications used, and daily and cumulative preservative concentrations (PC). Main outcome measures were fluorescein corneal staining score (Oxford scale), lower tear meniscus height (LTMH) (spectral-domain optical coherence tomography), noninvasive tear film breakup time (NI-TBUT) (Oculus Keratograph 5M), and OSD symptom questionnaire index (OSDI). Results Compared to controls, significantly higher OSDI (median [interquartile range] 10.24 [4.54-18.94] vs 2.5 [0-12.5]; p<0.001) and corneal staining (≥1: 64.93% vs 32.61%; p<0.001) scores were recorded in the medication group. The NI-TBUT and LTMH failed to vary between the groups (p>0.05). A higher daily PC was associated with a lower LTMH (R −0.142; p = 0.043). In the medication group, multivariate analysis identified correlations between benzalkonium chloride (BAK) (odds ratio [OR] 1.56) and BAK plus polyquaternium-containing drops (OR 5.09) or higher OSDI (OR 1.06) and abnormal corneal staining test results and between older age (mean ratio [MR] 1.05), longer treatment duration (MR 1.02), or corneal staining presence (MR 1.22) and a higher OSDI score. Conclusions Ocular surface disease was more prevalent in the medication group. The main factors impacting OSD were drops with preservatives, longer treatment duration, and older age.

scholarly journals A comparative study of benzalkonium chloride-free latanoprost versus benzalkonium chloride-preserved latanoprost on ocular surface health in patients of primary open angle glaucoma

2017 ◽  
Vol 6 (5) ◽  
pp. 1110 ◽  
Author(s):  
Hema Chhabra ◽  
Anita Gupta ◽  
Gursatinder Singh
Keyword(s):  
Ocular Surface ◽  
Benzalkonium Chloride ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Tear Film ◽  
Ocular Surface Disease ◽  
Open Angle ◽  
Schirmer Test ◽  
Break Up ◽  
Ocular Surface Health

Background: Prolonged use of anti-glaucoma therapy leads to development of ocular surface disease (OSD). The purpose of this study was to compare the effect of Benzalkonium chloride (BKC)-free latanoprost and Benzalkonium chloride (BKC)-preserved latanoprost on ocular surface health in patients of primary open angle glaucoma (POAG).Methods: This was a prospective, open-label, randomized, interventional, switch trial. 30 established cases of POAG who were already on BKC-preserved latanoprost for atleast more than three months were enrolled. Their Schirmer test and Tear film break-up time (TBUT) were recorded at the baseline. They were required to answer an ocular surface disease index (OSDI) questionnaire from which an OSDI score was calculated. They were switched to BKC-free latanoprost for another three months. On their follow-up visit at 6 weeks and 12 weeks, Schirmer test and Tear film break up time were performed again and OSDI score was calculated.Results: Schirmer test increased from 6.73±3.77 mm at baseline to 9.53±3.67 mm at 6 weeks and 11.97±3.53 mm at 12 weeks (p=0.001). Mean TBUT improved significantly from 6.77±3.82 seconds at baseline to 8.63±3.91 seconds at 6 weeks to 10.47±3.76 seconds at 12 weeks (p=0.001). OSDI score decreased from 31.55±23.32 at baseline to 23.42±21.93 at 6 weeks to 15.82±20.10 at 12 weeks (p=0.001).Conclusions: BKC-free latanoprost led to improvement in tear film status or ocular surface health of glaucoma patients as compared to BKC-preserved latanoprost.

scholarly journals Ocular surface disease incidence in patients with open-angle glaucoma

2016 ◽  
Vol 144 (7-8) ◽  
pp. 376-383
Author(s):  
Marija Radenkovic ◽  
Gordana Stankovic-Babic ◽  
Predrag Jovanovic ◽  
Jasmina Djordjevic-Jocic ◽  
Marija Trenkic-Bozinovic
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Open Angle Glaucoma ◽  
Disease Incidence ◽  
Tear Film ◽  
Ocular Surface Disease ◽  
Delphi Panel ◽  
Open Angle ◽  
Pseudoexfoliative Glaucoma ◽  
Film Instability

Introduction. Ocular surface disease (OSD) is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbances, tear film instability with potential damage to the ocular surface, accompanied by increased tear film osmolarity and inflammation of the ocular surface. It is a consequence of disrupted homeostasis of lacrimal functional unit. The main pathogenetic mechanism stems from tear hyperosmolarity and tear film instability. The etiological classification is hyposecretory (Sy-Sj?gren and non-Sj?gren) and evaporative (extrinsic and intrinsic) form. Delphi panel classification grades disease stages. Antiglaucoma topical therapy causes exacerbation or occurrence of symptoms of dry eye due to main ingredients or preservatives (benzalkonium chloride - BAK), which are dose- and time-dependent. BAK reduces the stability of the lipid layer of tears, the number of goblet cells, induces apoptosis and inflammatory infiltration. Objective. The aim of this study was the analysis of the OSD incidence in open-angle glaucoma patients caused by topical medicamentous therapy. Methods. Retrospective analysis of examined patients with open-angle glaucoma was used. Results. Increased incidence of moderate and advanced OSD Index degrees in the group of primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma. According to the Delphi Panel Scale the most common grade is IIb (POAG and pseudoexfoliative glaucoma). Evaporative form of OSD prevailed in all treatment groups. High percentage of dry eye in patients with higher concentrations of preservatives applied was noticed. Conclusion. OSD should be timely diagnosed and treated. Dry eye has an impact on surgical outcome and postoperative visual acuity, and in order to improve patient compliance and quality of life, symptoms of dry eye should be addressed and medications with lower concentrations of preservatives should be applied.

scholarly journals Changes in Ocular Surface Disease Evaluated after Nonpenetrating Deep Sclerectomy

2021 ◽  
Author(s):  
Carlota Fuente-García ◽  
Francisco José Muñoz-Negrete ◽  
Elisabet de Dompablo-Ventura ◽  
Javier Moreno-Montañés ◽  
Gema Rebolleda
Keyword(s):  
Ocular Surface ◽  
Anterior Segment ◽  
Tear Film ◽  
Ocular Surface Disease ◽  
Control Group ◽  
Deep Sclerectomy ◽  
Ocular Surface Disease Index ◽  
Non Invasive ◽  
Group A ◽  
Tear Meniscus Height

Abstract Objective: To analyse the ocular surface changes in eyes after the withdraw of anti-glaucomatous drugs when non-penetrating deep sclerectomy (NPDS) is performed.Methods: 31 patients (33 eyes) diagnosed of glaucoma that underwent NPDS, were included in this prospective study. Control group included 33 eyes of 33 age and sex-matched volunteers. Five variables were studied with Keratograph 5M (K5M): ocular hyperaemia (OH), non-invasive tear film break-up time (NI-BUT), lower tear meniscus height (LTMH) and meibography. LTMH was also measured using the anterior segment module of Spectralis Fourier-Domain Optical Coherence Tomography (FD-OCT). Also, an evaluation of corneal and conjunctival staining was performed.In addition, patients were asked to answer two questionnaires: Ocular Surface Disease Index (OSDI) and National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) before and 6-months after surgery.Results: Before NPDS, treated eyes, showed worse objective data than healthy controls (p ≤0.049). In this group, a significant improvement was observed in the questionnaires (p< 0.001), LTMH FD-OCT (p=0.037) and LTMH K5M (p=0.025), K5M OH (p=0.003), NI-BUT (=0.022) and conjunctival and corneal staining (p<0.001). No significant differences were observed between groups in FD-OCT and K5M LTMH, NI-BUT, corneal-conjunctival staining and in the most OH sector values at 6 months(p ≥0.62).Conclusion: A significant improvement in the ocular surface was observed 6 months after NPDS, suggesting that the withdrawn of the topical anti-glaucomatous treatment has a beneficial effect.

scholarly journals Diagnosis and Treatment Methods for Ocular Surface Disease in Glaucoma

2014 ◽  
Vol 08 (01) ◽  
pp. 40
Author(s):  
Gemma C M Rossi ◽  
Keyword(s):  
Ocular Surface ◽  
Diagnostic Tests ◽  
Benzalkonium Chloride ◽  
Tear Film ◽  
Daily Practice ◽  
Ocular Surface Disease ◽  
Anterior Surface ◽  
Treatment Methods ◽  
Associated Diseases

Glaucoma and ocular surface disease (OSD) are often concomitant disorders (OSD is the consequence of a tear film dysfunction that may be due to several conditions). The aims of the paper are to suggest a sequence of diagnostic tests easy to perform in daily practice, both subjective and objective, to detect the onset of the OSD; and, second, to propose how to prevent and, if the case, how to manage the OSD. Briefly, tear film break-up time (TF-BUT) and corneal/conjunctival staining are suggested to detect the main signs of OSD. In terms of therapy, the long-term exposure to benzalkonium chloride (BAK) should be minimised, preferring non-BAK-preserved or BAK-free glaucoma medications, where available, as well as fixed combinations. The treatment of associated diseases of the anterior surface may reduce signs; use of non BAK-preserved tears may reduce symptoms.

scholarly journals Changes in Tear-Film Status and Ocular Surface Disease Index Score Following Prolonged Use of Face Mask

2021 ◽  
Vol 11 (04) ◽  
pp. 253-265
Author(s):  
Nawreen Binte Anwar ◽  
Basil Anwar ◽  
Arup Krishna Choudhury ◽  
Mahfuza Rahman Khan ◽  
Md. Anisur Rahman
Keyword(s):  
Ocular Surface ◽  
Tear Film ◽  
Face Mask ◽  
Disease Index ◽  
Index Score ◽  
Ocular Surface Disease ◽  
Ocular Surface Disease Index ◽  
Score Following

Noninvasive Imaging of Tear Film Dynamics in Eyes With Ocular Surface Disease

Cornea ◽  
2015 ◽  
Vol 34 ◽  
pp. S48-S52 ◽  
Author(s):  
Nizar Saleh Abdelfattah ◽  
Anna Dastiridou ◽  
SriniVas R. Sadda ◽  
Olivia L. Lee
Keyword(s):  
Ocular Surface ◽  
Noninvasive Imaging ◽  
Tear Film ◽  
Ocular Surface Disease

scholarly journals Morphological and Functional Assessment of Meibomian Glands in Keratoconus

2021 ◽  
Author(s):  
Ömür Ö Uçakhan ◽  
Gökçen Özcan
Keyword(s):  
Ocular Surface ◽  
Tear Film ◽  
Early Screening ◽  
Ocular Surface Disease Index ◽  
Non Invasive ◽  
The Mean ◽  
Meibomian Glands ◽  
Break Up ◽  
And Function ◽  
Corneal Staining

Abstract Purpose: To evaluate the morphology and function of the meibomian glands (MG) in keratoconus patients.Methods: One hundred eyes of 100 keratoconus patients and 100 eyes of 100 age-matched healthy subjects were included into this study. Ocular Surface Disease Index (OSDI) scores, non-invasive break up time (NIBUT), meibography findings, fluorescein staining of the ocular surface, tear film break-up time (TBUT), and Schirmer I test were recorded in all patient eyes and were compared with controls.Results: The mean TBUT and NIBUT were significantly lower, corneal staining and OSDI scores were statistically higher in the keratoconus group (p<0.05). The mean meiboscore, partial gland, gland dropout and gland thickening scores of the upper and lower eyelids were significantly higher in keratoconus patients compared to controls (p<0.05). The NIBUT measurements significantly correlated with MG loss in both upper and lower eyelids (p<0.05). The severity of keratoconus seemed to correlate with meiboscore, partial gland, gland thickening scores in both upper and lower eyelids. Conclusion: Our data suggest that corneal ectasia in keratoconus is associated with alterations in ocular surface, tear film function and MG morphology. Early screening and treatment of MG dysfunction may improve ocular surface quality and allow better disease management in keratoconus patients.

scholarly journals OCULAR SURFACE DISEASE AMONG PATIENTS WITH OPEN ANGLE GLAUCOMA USING TOPICAL ANTI-GLAUCOMA MEDICATIONS

2021 ◽  
Vol 71 (6) ◽  
pp. 2041-44
Author(s):  
Hassaan Javaid ◽  
Omar Zafar ◽  
Seemal Akram ◽  
Sana Abbas ◽  
Ikram Ullah Khan ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
Armed Forces ◽  
Disease Index ◽  
Ocular Surface Disease ◽  
Common Finding ◽  
P Value ◽  
Open Angle ◽  
Ocular Surface Disease Index

Objective: To determine the frequency of ocular surface disease among patients with open angle glaucoma using topical antiglaucoma medications presenting at a tertiary care eye hospital. Study Design: Cross-sectional analytical study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from May 2019 to Jan 2020. Methodology: One hundred and eighty patients aged 18 or more, with open angle glaucoma using any of the topical antiglaucoma medications including preparations of dorzolamide, brimonidine, timolol, levobunolol, betaxolol, latanoprost, travoprost, bimatoprost or a combination of these for more than six months took part in the study. Ocular surface disease index was used to assess the presence and severity of ocular surface disease. Results: Out of 180 patients of glaucoma managed with topical anti-glaucoma medications, 83 (46.1%) did not show presence of ocular surface disease when ocular surface disease index was administered. Twenty-nine (16.1%) patients had mild symptoms, 17 (9.4%) had moderate symptoms while 51 (28.3%) patients reported severe symptoms of ocular surface disease. Advancing age and longer duration of treatment with topical anti-glaucoma medications had statistically significant association with the presence of ocular surface disease (p-value <0.05). Conclusion: Presence of ocular surface disease was a common finding among patients using topical agents for the management of glaucoma. Advancing age and prolonged use of anti-glaucoma medication emerged as risk factors statistically related to the presence of ocular surface disease.

scholarly journals Comparative characteristics of osmolarity, tear production and state of the corneal epithelium after instillations of the preparations Visomitin and hypromellose

2021 ◽  
pp. 249-255
Author(s):  
T. N. Safonova ◽  
Z. V. Surnina ◽  
G. V. Zaitseva
Keyword(s):  
Ocular Surface ◽  
Tear Film ◽  
Quantitative Composition ◽  
Blurred Vision ◽  
Ocular Symptoms ◽  
Increased Sensitivity ◽  
Corneal Staining ◽  
Positive Effect ◽  
Inflammatory Action

Introduction. Dry eye syndrome (DES) is a multifactorial disease of the ocular surface, characterized by changes in its homeostasis and accompanied by ocular symptoms, the etiology of which is associated with destabilization of the tear film, hyperosmolarity, inflammation, damage to the structures of the ocular surface and neurosensory disorders.Objective. To study the effect of a drug containing plastoquinonyldecyltriphenylphosphonium bromide (PDTP, SkQ1) on dynamics of osmolarity and reparative properties of the cornea.Materials and methods. The study included 23 patients (46 eyes) aged 23 to 49 years. All patients presented complaints of dryness, burning sensation, cramps and discomfort in the eyes, increased sensitivity with instillation of drops, periodic blurred vision. Patients underwent standard and special ophthalmic examinations. The patients were divided into two groups comparable in gender and quantitative composition.Results. Based on the results of the examination at the starting visit, all patients were diagnosed with DES mild or moderate study. After one week of therapy, a significant decrease in subjective complaints was noted patients who received the drug with PDTF. All patients tolerated the drug well. In the group of patients who received a tear replacement therapy with hypromellose, in most patients, while complaints of dryness persist, decreased a feeling of pain in the eyes. A month later, complaints persisted only in patients of this group, but their intensity was known significantly reduced compared to the visit after a week. Against the background of therapy with the drug with PDTP, significant improvement of the Schirmer test, Norn test and corneal staining, as well as with the help of a in vivo confocal microscopy shows a decrease in the number of Langerhans cells.Conclusion. The results obtained indicate a positive effect of PDTP on the structure of the ocular surface even with its short-term use due to its keratoprotective and anti-inflammatory action. 

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