Adverse effects of topical antiglaucoma drugs on the ocular surface

Arıcı, Mustafa Kemal; Arıcı, Dilek Sema; Topalkara, Ayşen; Güler, Cenap

doi:10.1046/j.1442-9071.2000.00237.x

Cited by 132 publications

(78 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…First, corneal and conjunctival fluorescein staining was not evaluated, although this has been extensively studied in the past. 25,35,39,[46][47][48] Second, our study did not consider the possibility that glaucoma patients' (in the medicated and posttrabeculectomy groups) tear function may be due to dry eye that was independent of their glaucoma treatment. Glaucoma patients on concomitant systemic (eg, hormonal pills) 49 or ocular medications (eg, artificial tear lubricants), 50 which can affect dry eye test parameters, were also not considered.…”

Section: Discussionmentioning

confidence: 99%

“…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. 27 We hypothesize that TFO may be raised in glaucoma patients, both on topical therapy and post trabeculectomy, compared with normal controls.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Lee

Wong

Chua

et al. 2013

Eye

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Lee

Wong

Chua

et al. 2013

Eye

View full text Add to dashboard Cite

show abstract

“…Topical hypotensive therapy with fixed combinations (prostaglandin analog and beta blocker eye drops) has been observed to increase the expression of the inflammatory markers HLA-DR and interleukin-6 with resultant deterioration in the ocular surface after three months of therapy. 27,28 The anti-inflammatory effect of topical cyclosporine 0.05% administered twice daily has been proven to be beneficial to reduce the inflammatory effects of mild to moderate dry eye disease. 15,20 Our study evaluated the concurrent effect of topical cyclosporine 0.05% therapy on the ocular surface in patients of long-term ocular hypotensives.…”

Section: Discussionmentioning

confidence: 99%

Topical cyclosporine to control ocular surface disease in patients with chronic glaucoma after long-term usage of topical ocular hypotensive medications

Saini

Dhiman

Dada

et al. 2015

Eye

View full text Add to dashboard Cite

Purpose To evaluate changes in ocular surface and central corneal sub-basal nerve fiber layer (SBNFL) after topical cyclosporin therapy in chronic glaucoma patients on long-term topical antiglaucoma therapy. Methods A prospective comparative study of ocular surface evaluation of chronic glaucoma patients on long-term topical therapy treated concurrently with a topical cyclosporine 0.05% twice daily for 6 months and controls was done. The study parameters evaluated at recruitment and at the 6-month follow-up included details of topical antiglaucoma medications, visual acuity, intraocular pressure, ocular surface evaluation parameters (TBUT, Schirmers I, ocular surface staining scores and ocular surface disease (OSD) index score (OSDI)), central corneal sensation (Cochet Bonnett aesthesiometer), and central confocal microscopy to study the SBNFL density (SBNFLD). Results Thirty-two eyes of 16 patients with chronic glaucoma and 30 eyes of 15 normal subjects as controls were studied. Mean TBUT, pre/post CsA treatment was 8.67 ± 3.01/12.24 ± 1.83 s (P = 0.007). Mean conjunctival/corneal staining scores pre/post CsA treatment were 3.38 ± 1.93/1.50 ± 0.718 (P = 0.00) /5.19 ± 1.82/1.81 ± 0.78 (P = 0.098), respectively. Mean OSDI pre/post CsA treatment scores were 30.63 ± 14.61/14.76 ± 6.06 (P = 0.007). Mean corneal sensations scores pre/post CsA treatment were 4.64 ± 0.46/4.94 ± 0.39 (P = 0.002). Central corneal SBNFLD pre and post CsA treatment was 8811.35 ± 2985.29/10335.13 ± 4092.064 μm/mm 2 (P = 0.0001).Conclusions Schirmer's test, ocular surface staining scores, OSDI, corneal sensations, and corneal SBNFLD showed a statistically significant improvement following a 6-month concurrent topical CsA therapy.

show abstract

“…We used IVCM because this technique is minimally invasive, and it is effective in evaluating the histopathology of surface disease (Mastropasqua et al 2006;Messmer et al 2006;Hong et al 2010;Le et al 2010;Wakamatsu et al 2010;Zhu et al 2010) and the toxic effects of glaucoma therapy (Arici et al 2000;Messmer et al 2006;Ciancaglini et al 2008;Martone et al 2009;Bergonzi et al 2010). Our study showed that no changes occurred throughout followup in both controls and patients treated with preservative-free timolol; on the opposite, BAK-preserved eye drops were associated with signs of ocular surface inflammation (lower goblet cell density and epithelial irregularity) after 12 months of treatment.…”

Section: Discussionmentioning

confidence: 99%

In vivo confocal microscopy of conjunctiva in preservative‐free timolol 0.1% gel formulation therapy for glaucoma

Frezzotti

Fogagnolo

Haka

et al. 2013

Acta Ophthalmologica

View full text Add to dashboard Cite

ABSTRACT.Purpose: To evaluate the effects at 1 year of preservative-free timolol gel and preserved timolol eye drops on conjunctiva and tear parameters. Methods: Forty patients with primary open-angle glaucoma or ocular hypertension were randomized to the two treatment groups and compared with 20 healthy age-matched controls. Clinical tests (IOP, Schirmer I test, and lacrimal film break-up time BUT) and in vivo conjunctival confocal microscopy (IVCM) were performed in all patients at baseline and after 12 months. IVCM (HRT II Rostock Cornea Module; Heidelberg Engineering GmbH, Heidelberg, Germany) was performed after topical anaesthesia in the four cardinal locations and at the corresponding limbus to analyse conjunctiva cells. The main IVCM outcomes were goblet cell density and epithelial regularity. Results: IVCM and clinical parameters were similar in the three groups at baseline. After 12 months, intra-epithelial goblet cell density was significantly lower in the preserved (48.25 AE 7.70) than in the preservative-free beta-blocker group (86.83 AE 22.17, p < 0.001) and controls (88.9 AE 18.33, p < 0.001). The epithelial layer was significantly more regular in the preserved beta-blocker medication group than in the preservative-free beta-blocker group (p < 0.001) and the control group (p < 0.001). A significant reduction in both Schirmer I and BUT was found in the group of preserved timolol (respectively, 11.3 AE 2.97 and 8.12 AE 0.99) compared with preservative-free timolol (16.8 AE 1.83 and 11.27 AE 1.27, p < 0.001) and controls (17.8 AE 1.87 and 12.10 AE 1.28, p < 0.001). Conclusions: Based on our IVCM data, preservative-free beta-blocker gel induces less changes at ocular surface than preserved beta-blockers, a fact that should be considered to obtain less adverse effects and maximal adherence to treatment in a chronic condition such as glaucoma.

show abstract

Adverse effects of topical antiglaucoma drugs on the ocular surface

Abstract: The conclusion was that it is possible that conjunctival surface and tear film function change after the long-term use of antiglaucoma medication.

Cited by 132 publications

References 17 publications

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

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

Topical cyclosporine to control ocular surface disease in patients with chronic glaucoma after long-term usage of topical ocular hypotensive medications

In vivo confocal microscopy of conjunctiva in preservative‐free timolol 0.1% gel formulation therapy for glaucoma

Contact Info

Product

Resources

About