Ocular Surface Disease Exacerbated Glaucoma

Batra, Ruchika; Tailor, Rajen; Mohamed, Saifullah

doi:10.1097/ijg.0b013e318264cd68

Cited by 62 publications

(27 citation statements)

References 15 publications

(13 reference statements)

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“…It has been established, however, that combined antiglaucoma therapy can adversely influence adherence, tolerability, and ocular tissue health [4–6]. These parameters markedly reduce the success of long-term medical therapy [6, 7]. Treatment advances have been introduced to facilitate the success of combined therapy in real life.…”

Section: Introductionmentioning

confidence: 99%

24-Hour Efficacy and Ocular Surface Health with Preservative-Free Tafluprost Alone and in Conjunction with Preservative-Free Dorzolamide/Timolol Fixed Combination in Open-Angle Glaucoma Patients Insufficiently Controlled with Preserved Latanoprost Monotherapy

et al. 2016

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IntroductionThe aim of the present study was to evaluate the 24-h efficacy, tolerability, and ocular surface health with preservative-free (PF) tafluprost and a PF triple drug regimen comprising tafluprost and dorzolamide/timolol fixed combination (DTFC) in open-angle glaucoma patients who were insufficiently controlled with preserved branded or generic latanoprost monotherapy and who exhibited signs or symptoms of ocular surface disease (OSD).MethodsProspective, observer-masked, crossover, comparison. Eligible consecutive open-angle glaucoma patients were randomized to either PF tafluprost or the triple PF regimen for 3 months. They were then crossed over to the opposite therapy for another 3 months. At the end of the latanoprost run-in period and after each PF treatment period, patients underwent habitual 24-h intraocular pressure (IOP) monitoring with Goldmann tonometry in the sitting position (at 10:00, 14:00, 18:00, and 22:00) and Perkins tonometry in the supine position (at 02:00 and 06:00). Tolerability and selected ocular surface parameters were evaluated at baseline and the end of each treatment period.ResultsForty-three open-angle glaucoma patients completed the trial. Mean 24-h IOP on preserved latanoprost was 22.2 ± 3.9 mmHg. Compared with latanoprost monotherapy, PF tafluprost obtained a greater reduction in mean, peak, and fluctuation of 24-h IOP including the 02:00 and 06:00 time points (P < 0.05). With the exception of 24-h fluctuation, the triple PF regimen provided significantly lower IOP parameters than latanoprost or PF tafluprost (P < 0.001). Finally, PF tafluprost therapy displayed significantly improved tear film break-up times (6.7 vs 6.0 s), corneal staining (1.3 vs 2.2), and Schirmer I test results (9.1 vs 8.2 mm) compared with the preserved latanoprost baseline (all P < 0.01). The triple PF regimen demonstrated similar tear film break-up times (6.1 vs 6.0 s) and Schirmer I test results (8.2 vs 8.2 mm) to latanoprost, but revealed a significant improvement in the corneal stain test (1.7 vs 2.2; P < 0.001).ConclusionsIn this trial PF tafluprost therapy provided statistically greater 24-h efficacy and improved tolerability compared with preserved latanoprost. The combination of PF tafluprost and PF dorzolamide/timolol fixed combination was statistically and clinically more efficacious than both monotherapies and demonstrated similar ocular surface characteristics to preserved latanoprost monotherapy.Trial registrationClinicalTrials.gov (NCT02802137).FundingSanten.

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Section: Introductionmentioning

confidence: 99%

24-Hour Efficacy and Ocular Surface Health with Preservative-Free Tafluprost Alone and in Conjunction with Preservative-Free Dorzolamide/Timolol Fixed Combination in Open-Angle Glaucoma Patients Insufficiently Controlled with Preserved Latanoprost Monotherapy

et al. 2016

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“…There was a trend towards lowering IOP following OSD treatment; furthermore, 58% of the eyes had an IOP reduction of at least 2 mmHg after OSD treatment. These findings can be explained either by the minimization of inflammatory stimuli that could affect the trabecular meshwork, 22,29 or by a significant increase in compliance due to the reduced discomfort. Although only one patient reported having missed more than one antiglaucoma drop in a week through our questionnaire, self-reported compliance is questionable and often overestimated.…”

Section: Discussionmentioning

confidence: 99%

“…21 OSD management in glaucoma patients has been previously investigated, demonstrating clinical and symptomatic improvement along with better IOP control in a sample of four patients evaluated by subjective parameters. 22 This study aims to evaluate the prevalence of OSD in glaucoma patients under topical treatment, quantifying symptoms and measuring objective ocular surface parameters. Furthermore, this study evaluates the impact of OSD treatment on IOP control, improvement of ocular surface parameters and symptoms.…”

Section: Introductionmentioning

confidence: 99%

<p>Impact of Ocular Surface Disease Treatment in Patients with Glaucoma</p>

Boso¹,

Gasperi²,

Fernandes³

et al. 2020

OPTH

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Purpose: Chronic topical treatment for glaucoma may lead to Ocular Surface Disease (OSD). This study aimed to evaluate: (1) the prevalence of OSD in glaucoma patients under topical treatment, quantifying symptoms and objective ocular surface parameters and (2) the impact of ocular surface treatment on OSD and IOP control. Methods: Patients with primary open angle or primary angle closure glaucoma under topical treatment for at least 6 months were enrolled in the study. Patients underwent symptom screening with the ocular surface disease index (OSDI) questionnaire, assessment of objective ocular surface parameters, ocular surface staining and Schirmer test. A treatment for OSD with eyelid hygiene, fluorometholone acetate 0.1%, preservative-free lubricants, free-acid supplementation and oral tetracyclin derivate was started, and the same evaluation was performed. Results: In our sample (n=19), 73.68% of the patients reported severe symptoms of dry eye disease, with OSDI scores higher than 33 at baseline. Tear film instability was found in 50% of patients, while 23.53% had severe meibomian gland abnormalities. Fluorescein and lissamine green stainings were abnormal in 88.24% and 82.35% of patients, respectively. After ocular surface treatment, statistically significant improvement was found in bestcorrected visual acuity (p=0.0003), OSDI score (p<0.0001), bulbar redness (p=0.0196) and fluorescein staining (p<0.0001.) Mean IOP following OSD treatment reduced −1.59 mmHg from baseline in the left eye (p=0.0510). Conclusion: The prevalence of OSD signs and symptoms was high in glaucoma patients under medical treatment. Short-term OSD treatment may improve ocular surface disease and IOP control, with no need to discontinue glaucoma medications.

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“…In this study, ocular hypertension resolved in 67% of the patients after lowering the dose of topical or systemic corticosteroids. Interestingly, one report showed that improvement in the ocular surface condition enhanced IOP control in patients with glaucoma and concurrent ocular surface disease [15]. The decision to treat ocular hypertension with anti-glaucoma medications should weigh the risks of sustained OHT against their toxicity on the ocular surface.…”

Section: Discussionmentioning

confidence: 99%

“…The use of steroids, the presence of inflammation, and scarring are some of the suggested mechanisms that lead to increased intraocular pressure (IOP) in patients with ocular surface disease [10,12,14,15]. Systemic corticosteroids are a standard treatment in many patients with systemic GVHD, and patients with ocular GVHD usually receive topical corticosteroids.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of ocular hypertension and glaucoma in patients with chronic ocular graft-versus-host disease

Saboo

Amparo

Shikari

et al. 2016

Graefes Arch Clin Exp Ophthalmol

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Purpose To evaluate the prevalence of ocular hypertension (OHT) and glaucoma in patients with chronic ocular graft-versus-host disease (GVHD). Methods We performed a retrospective chart review of 218 patients diagnosed with chronic ocular GVHD. Ocular hypertension was defined as intraocular pressure (IOP) ≥ 24 mm Hg in either eye without any glaucomatous optic disc changes. Glaucoma suspect was defined as optic disc changes with a cup-disc ratio ≥ 0.7 in either eye or asymmetry of ≥ 0.3 between the two eyes. Glaucoma was defined by glaucomatous optic disc changes plus glaucomatous visual field defects in two consecutive reliable visual field tests. Number of cases of ocular hypertension, glaucoma, and glaucoma suspects was evaluated. Results Thirty-three patients (15%) were diagnosed with OHT, eight patients (3.6%) with suspicion of glaucoma, and one patient (0.4%) with glaucoma. OHT occurred within six months of developing ocular GVHD in 60% of the cases and within the first year in 76%. High IOP normalized in 67% of patients when the dosage of topical or systemic corticosteroids was lowered, and 27% of patients required anti-glaucoma therapy. Conclusion Ocular hypertension is a common complication in patients with ocular GVHD, with a prevalence of 15%. The rise in intraocular pressure is often transient and resolves with management of corticosteroids in most cases. However, clinicians should be aware that nearly one-third of the patients with OHT might require anti-glaucoma treatment. The prevalences of glaucoma and suspicion of glaucoma were not higher than in the general population.

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Ocular Surface Disease Exacerbated Glaucoma

Cited by 62 publications

References 15 publications

24-Hour Efficacy and Ocular Surface Health with Preservative-Free Tafluprost Alone and in Conjunction with Preservative-Free Dorzolamide/Timolol Fixed Combination in Open-Angle Glaucoma Patients Insufficiently Controlled with Preserved Latanoprost Monotherapy

24-Hour Efficacy and Ocular Surface Health with Preservative-Free Tafluprost Alone and in Conjunction with Preservative-Free Dorzolamide/Timolol Fixed Combination in Open-Angle Glaucoma Patients Insufficiently Controlled with Preserved Latanoprost Monotherapy

<p>Impact of Ocular Surface Disease Treatment in Patients with Glaucoma</p>

Prevalence of ocular hypertension and glaucoma in patients with chronic ocular graft-versus-host disease

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