Prevalence of Ocular Surface Complaints in Patients With Glaucoma Using Topical Intraocular Pressure-Lowering Medications

Fechtner, Robert D.; Godfrey, David G.; Budenz, Donald L.; Stewart, Jeanette A.; Stewart, William C.; Jasek, Mark C

doi:10.1097/ico.0b013e3181c325b2

Cited by 294 publications

(244 citation statements)

References 16 publications

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“…Mean/median rates of OSDI scores within the abnormal range in treated glaucoma patients reported by others are slightly higher than ours: 18.97 ± 9.5% (22), 11.1% (5-22.5) (25), and 16.7% (19). While some authors report no significant differences compared with control subjects not receiving antiglaucoma eyedrops (20,(25)(26)(27) several others note a difference in OSD prevalence (18,19,22,24), as observed here. Although the latter rates were similar to those of the present study, the slightly higher reported rates could be attributed to differences in demographics, such as ethnicity or sex (black individuals and women show a higher prevalence of OSD (21,36)), treatment duration (23), previous ocular conditions or surgery, and glaucoma severity (18,19).…”

Section: Discussioncontrasting

confidence: 48%

“…The lack of correlation between signs and symptoms of OSD has been attributed to BAK-preserved eyedrops decreasing corneal sensitivity (38,39), perhaps by reducing sub-basal corneal nerve density (37). While some authors have not been able to correlate the number of preservative-containing eyedrops used with symptoms (17,19,20,23,25,40), others have detected such correlation (18,21,22,24). What has been clearly established is that effects of the glaucoma treatment burden can include OSD symptoms such as irritation, burning, dryness, photophobia, or foreign body sensation.…”

Section: Discussionmentioning

confidence: 99%

“…This total score was recorded for each participant. The impact of dry eye was then assessed categorically as normal (scores of 0-12), mild (scores of [13][14][15][16][17][18][19][20][21][22], moderate (scores of [23][24][25][26][27][28][29][30][31][32], or severe (scores of 33-100), as previously described (17,24).…”

Section: Ocular Surface Disease Indexmentioning

confidence: 99%

“…However, there is controversy over whether drug-or preservative-induced OSD causes a higher prevalence of symptoms and a poorer quality of life. Thus, while numerous clinical studies report high scores using validated symptom-assessing questionnaires in glaucoma patients under topical treatment (18,(21)(22)(23)(24), other studies have detected no differences in scores between patients under treatment with antiglaucoma eyedrops and untreated individuals (20,(25)(26)(27).…”

Section: Introductionmentioning

confidence: 99%

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Ocular Surface Disease in Patients under Topical Treatment for Glaucoma

Pérez-Bartolomé

Martínez-de-la-Casa

Arriola‐Villalobos

et al. 2017

European Journal of Ophthalmology

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ORIGINAL RESEARCH ARTICLE disease, conjunctivitis, and keratitis (3). Ocular surface disease is frequently observed in glaucoma patients and is thought to be the consequence of the chronic use of IOP-lowering eyedrops (4, 5). As a comorbidity of glaucoma, OSD has been held responsible for poor treatment adherence (6) and worsening of patient quality of life (6, 7). In treated glaucoma patients, abnormal tear film function has been detected using objective tests such as fluorescein corneal staining, tear film breakup time (TBUT), osmolarity, or meibomian gland score, although the severity of symptoms varies widely among studies (8-11). Both OSD and glaucoma are age-related diseases (7, 12), though individuals with glaucoma show a higher prevalence of OSD than do those without glaucoma (13). There is increasing evidence to suggest that the preservatives used in antiglaucoma medications may worsen the signs and symptoms of OSD. Benzalkonium chloride (BAK) is one of the first preservatives introduced and is currently the most widely used ophthalmic preservative. Several in vitro and animal studies have shown that solutions containing BAK cause corneal neurotoxicity, tear film disruption, and trabecular meshwork damage (14, 15). As a less harmful preservative,

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Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Section: Ocular Surface Disease Indexmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ocular Surface Disease in Patients under Topical Treatment for Glaucoma

Pérez-Bartolomé

Martínez-de-la-Casa

Arriola‐Villalobos

et al. 2017

European Journal of Ophthalmology

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“…The far majority of studies only reported symptoms 24 or the tear function tests with preset thresholds. 22,25,26 Another study reported that only 4.8% and 33.8% of patients on anti-glaucoma medications had TBUT and Schirmer's test values of 410 s and 410 mm, respectively, as compared with a healthy population of 100% above these thresholds.…”

Section: Introductionmentioning

confidence: 99%

Effect of chronic anti-glaucoma medications and trabeculectomy on tear osmolarity

Lee

Wong

Chua

et al. 2013

Eye

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Purpose To evaluate the tear film osmolarity (TFO) and ocular surface clinical signs and symptoms in chronically medicated glaucoma patients and post-trabeculectomy patients. Methods This is a single-center, prospective case-controlled study. One-hundred and thirty eyes of 130 participants aged Z45 years were included (49 normal controls, 50 glaucoma patients on chronic preserved antiglaucoma medication Z6 months, and 31 post-trabeculectomy patients not on medication Z6 months). TFO, tear break-up time (TBUT), Schirmer's test I and dry eye symptoms were evaluated. Data from both groups of glaucoma patients were compared with age and sex-matched controls. Logistic regression was performed to calculate the odds ratios. Results Mean TFO in the three groups were 301.4 ± 7.7, 307.0 ± 9.3, and 307.4 ± 11.6 mOsm/l, respectively. Compared with normal controls, chronically medicated glaucoma patients and post-trabeculectomy patients were more likely to have a raised TFO, with odds ratios (95% CI) of 4.43 (1.74-11.32) and 2.76 (1.02-7.94), respectively. Both groups of glaucoma patients were also more likely to experience dry eye symptoms, with ORs of 4.72 (1.92-11.59) and 4.24 (1.54-11.72). There was no significant difference in TFO and symptoms between both groups of glaucoma patients, and in TBUT and Schirmer's test across all three groups. Conclusions Patients on chronic topical antiglaucoma medication and posttrabeculectomy patients were more likely to have raised TFO and dry eye symptoms, suggesting significant ocular surface disease. Glaucoma practitioners should be aware that dry eye symptoms and raised TFO may occur in the absence of TBUT and Schirmer's test abnormality.

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