Oční klinika 1. lékařské fakulty Univerzity Karlovy a Ústřední vojenské nemocnice -Vojenské fakultní nemocnice Praha Nežádoucí účinky lokální antiglaukomové léčby mohou být příčinou špatné spolupráce pacienta v léčebném režimu. To může být důvodem progrese choroby. Pro lepší orientaci lékárníka a praktického lékaře v této oblasti jsou aktuální data z této oblasti sumarizována. Vybrané zvláště významné vztahy a klinické nálezy jsou komentovány.Klíčová slova: glaukom, medikamentózní léčba, lokální nežádoucí účinky. Ocular side effects of antiglaucoma drugsSubjective symptoms of local side effects of antiglaucomatics may decrease the patients compliance. For better orientation in this issue, the actual data and important clinical findings in this field have been summarized and discussed.

Purpose To investigate the ocular surface inflammation in patients with primary open angle glaucoma and ocular hypertension by analyzing tears and to compare findings with healthy controls. Methods Observational case–control study. Tear samples were collected by 5 µl microcapillary tube from 24 patients with glaucoma treated by antiglaucoma drops, 9 non-treated patients with ocular hypertension and 45 healthy controls. Tears were analyzed from right eye by multiplex Bio-Plex system for the presence of 6 cytokines: IL1β, IL10, IL4, IFNγ, MIF and VEGF. Results Significantly higher concentrations of IL1β and IL10 (glaucoma or ocular hypertension vs. healthy controls, p < 0.0001), VEGF (glaucoma vs. ocular hypertension, p < 0.05; ocular hypertension vs. healthy controls, p < 0.02) and MIF (glaucoma vs. healthy controls, p < 0.03) were detected in patients’ tears. Both patient groups have activated to a significantly lower extent the Th1 pathway represented by IFNγ than Th2 pathway represented by IL10 (p < 0.001) and, at the same time, the IFNγ/IL4 ratio was significantly increased in healthy controls (p < 0.001) and patients with ocular hypertension (p < 0.02) compared to glaucoma individuals. Conclusion This study shows that secretion of inflammation-related cytokines by conjunctival cells is increased in both, glaucoma and ocular hypertension patients and can be detected in their tears. Nevertheless, data indicates stronger ocular surface inflammation in non-treated follow-up patients diagnosed with ocular hypertension than in glaucoma subjects treated by antiglaucoma drops.