Purpose:
The purpose of this study was to evaluate the effect of treating ocular surface disease (OSD) in patients with medically uncontrolled primary open-angle glaucoma (POAG) associated with OSD.
Methods:
We compiled a retrospective observational case series of 10 patients with POAG that remained uncontrolled with topical treatments and who were referred for filtering glaucoma surgery. All patients underwent a complete assessment of their glaucoma and ocular surface for both eyes. The main treatments were change of topical antiglaucoma medications to preservative-free equivalents, removal of allergenic treatments or those identified as causing side effects, switch to another therapeutic class with the same efficacy but with a better safety profile and treatment of OSD.
Results:
After a minimum follow-up of 6 months, we observed improved ocular surface in all patients, associated with an intraocular pressure (IOP) decrease or stabilization even if some antiglaucoma medications were removed. The mean IOP significantly decreased from 23.75±9.98 mm Hg to 15.15±4.75 mm Hg (−36.2%; P=0.0001). The mean number of IOP-lowering medications was 3.7±1.06 at presentation and 2.8±0.63 after treatment (P=0.01). The Oxford score also decreased from a mean 1.7±0.67 to 0.4±0.51 (−76.5%; P<0.001). For 2 patients, IOP was not sufficiently reduced after treatment and they finally underwent filtering surgery.
Conclusions:
The prevalence of OSD in POAG patients is very high, particularly in patients with uncontrolled glaucoma with multiple topical medications. Careful management of the ocular surface associated with a reduction of the toxicity of eyedrops may result in improvement of ocular surface health and better IOP control.
FBs were associated with a higher number of intraepithelial microcysts evaluated with en-face OCT. A higher density of microcysts was associated with a lower intraocular pressure and a shorter duration of preserved topical treatment before surgery. En-face OCT provides a simple, noninvasive, and reproducible method to analyze blebs after filtering surgery.
Purpose Ischemic maculopathy with temporal macular thinning was recently described on OCT in patients with sickle cell disease. In the current study, we describe the features on Spectral Domain OCT(SD‐OCT)in three patients.
Methods We report 3 cases of sickle cell patients presenting ischemic maculopathy documented by ophthalmologic clinical evaluation, fluorescein angiography (FA),and SD‐OCT.
Results The three patients present stage 3 sickle cell peripheral ischemic retinopathy (Goldberg classification) and bilateral enlargement of ACV in FA. The first patient is a 35 year old man. SD‐OCT shows bilateral thinning in temporal macula retina. Thickness measurement is respectively in right and left eye, 271µm and 219 µm in foveolar region, 275µm and 302µm in temporal perifoveolar region, 203µm and 265 µm in temporal parafoveolar region. The second patient is aged 15. Angiograms reveal a small arteriolar occlusion in the right temporal macula. On SD‐OCT retinal thickness measurement is decreased in both temporal macula: 240µm and 261µm in foveolar region, 233µm and 265µm in temporal perifoveolar region vs 276µm and 358µm in nasal perifoveolar region, 199µm and 230 µm in temporal parafoveolar region vs 292µm and 319µm in nasal parafoveolar region (respectively in right and left eye). The third patient is aged 19 and present the same OCT aspect. Temporal retinal thinning is predominant in inner layers in the three patients.
Conclusion Sickle cell retinopathy can affect macular area through the same process of peripheral terminal vascular occlusion. SD‐OCT provides high resolution images that shows temporal macular thinning which is predominant in the retinal inner layers.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.