Ocular surface disease incidence in patients with open-angle glaucoma
2016
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-Sjogren and non-Sjogren) 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.
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