Dry Eye Syndrome-Related Quality of Life in Glaucoma Patients

Rossi, Gemma Caterina Maria; Tinelli, Carmine; Pasinetti, Giulio Maria; Milano, Giovanni; Bianchi, Paolo Emilio

doi:10.1177/112067210901900409

Cited by 179 publications

(158 citation statements)

References 39 publications

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“…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%

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: Discussionmentioning

confidence: 99%

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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“…Previous studies are showing a strong correlation between the number of IOP-lowering medications used and the presence of dry eye [8,16,17]. Study by Rossi et al [16] described the prevalence of OSD and they wanted to assess quality of life in subjects with glaucoma.…”

Section: Discussionmentioning

confidence: 99%

“…Study by Rossi et al [16] described the prevalence of OSD and they wanted to assess quality of life in subjects with glaucoma. In this study 40% of patients using 2 or 3 antiglaucoma medications had symptoms of OSD, which is in line with our findings.…”

Section: Discussionmentioning

confidence: 99%

“…Patients were grouped into 4 categories by OSDI score: normal (scores 0-12), mild OSD symptoms (13)(14)(15)(16)(17)(18)(19)(20)(21)(22), moderate OSD symptoms (23-32), severe OSD symptoms (33-100) [13]. Patients' medical records were used to obtain medical history including detailed data on the use of medication and duration of therapy.…”

Section: Clinical and Experimental Ophthalmologymentioning

confidence: 99%

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Prevalence of Ocular Surface Disease in Patients with Glaucoma using Topical Antiglaucoma Medications

Barišić¹

2014

J Clin Exp Ophthalmol

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Purpose: To establish the prevalence of ocular surface disease (OSD) in glaucoma patients using topical intraocular pressure-lowering (IOP) therapy and to compare the frequency and severity of symptoms with the control group of normal subjects. Methods:This prospective, multicenter, observational study included patients with glaucoma in four different Departments of Ophthalmology. A matched group of normal subjects served as controls. For each patient we have collected detailed family history, clinical records and calculated ocular surface disease index (OSDI) scores (0-100), based on the information obtained from OSDI questionnaires. Results:In total, we have evaluated 160 patients. Of those, 110 were glaucoma patients and 50 were normal subjects. Among 110 glaucoma treated patients 83 (75%) had OSDI scores indicating mild to severe OSD. Among 50 patients without glaucoma 15 (30%) had OSDI score indicating mostly mild to moderate OSD. The severity of symptoms correlates with the number of IOP medications used and the duration of treatment. Conclusion:This study confirms the high prevalence of OSD in patients treated for glaucoma with topical IOP medications. The adverse effect of these agents can influence the compliance and successful treatment of glaucoma patients.

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“…In short, BAK causes instability of the tear layer, loss of goblet cells, conjunctival squamous metaplasia, apoptosis, disruption of the corneal epithelial barrier and subclinical inflammation of the ocular surface. Several epidemiological studies have confirmed that about half of the patients treated with topical glaucoma medication have signs and ⁄ or symptoms of ocular surface disease (Jaenen et al 2007;Leung et al 2008;Rossi et al 2009;Fechtner et al 2010) and that this prevalence is higher in patients with glaucoma using preserved drops compared with patients using preservative-free drops (Pisella et al 2002). Much less is known about Benzalkonium chloride induces anterior chamber inflammation in previously untreated patients with ocular hypertension as measured by flare meter: a randomized clinical trial a potential effect of BAK on the deeper structures of the eye in vivo, although observations made in vitro on human trabecular meshwork cell lines and lens epithelial cells suggest a detrimental effect of BAK on these structures (Samples et al 1989;Hamard et al 2003;Goto et al 2003).…”

Section: Introductionmentioning

confidence: 99%

Benzalkonium chloride induces anterior chamber inflammation in previously untreated patients with ocular hypertension as measured by flare meter: a randomized clinical trial

Stevens

Kestelyn

Bacquer

2012

Acta Ophthalmologica

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ABSTRACT.Purpose: The deleterious effects of benzalkonium chloride (BAK) on the ocular surface are well known. However, few clinical data are available to prove a toxic effect at the level of the anterior chamber. The laser flare meter is a reliable tool to detect low levels of inflammation in the anterior chamber. We wanted to know whether instillation of BAK-preserved timolol in one eye would result in higher laser flare values than the instillation of preservativefree timolol in the fellow eye. Methods: Randomized prospective, single-masked clinical trial. Twenty-eight untreated patients with ocular hypertension were recruited. After obtaining baseline flare values, we randomly assigned one eye to BAK-preserved timolol and the fellow eye to preservative-free timolol. After 1 month, flare measurements were repeated. Results: There was a significant increase in the flare values in the two treatment regimens, but the increase in the BAK-treated eyes was higher than in the preservative-free treated eyes, and this difference in increase was statistically significant. Conclusion: This is the first study to show that short-term BAK administration produces inflammation in the anterior segment of previously untreated patients whose blood-aqueous barrier was not affected by recent intraocular surgery.

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Dry Eye Syndrome-Related Quality of Life in Glaucoma Patients

Cited by 179 publications

References 39 publications

Ocular Surface Disease in Patients under Topical Treatment for Glaucoma

Ocular Surface Disease in Patients under Topical Treatment for Glaucoma

Prevalence of Ocular Surface Disease in Patients with Glaucoma using Topical Antiglaucoma Medications

Benzalkonium chloride induces anterior chamber inflammation in previously untreated patients with ocular hypertension as measured by flare meter: a randomized clinical trial

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