Topical glaucoma medications – Clinical implications for the ocular surface

Fineide, Fredrik; Lagali, Neil; Adil, Muhammed Yasin; Arita, Reiko; Kolko, Miriam; Vehof, Jelle; Utheim, Tor Paaske

doi:10.1016/j.jtos.2022.07.007

Cited by 24 publications

(16 citation statements)

References 243 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Commonly used preservatives in eye‐drop formulations, especially benzalconium chloride, have well‐known toxic effects at the ocular surface (Burstein, 1980; Fineide et al, 2022; Wilson et al, 1975; Wu et al, 2011). The findings in studies with discrepancies in preservatives between comparative study arms are likely to have been influenced by these differences (Benitez‐del‐Castillo et al, 2002; Duan & Tang, 2021; Essa et al, 2018; Jun et al, 2019; Matsuo, 2004; Nelson & Farris, 1988).…”

Section: Discussionmentioning

confidence: 99%

A comparison between hyaluronic acid and other single ingredient eye drops for dry eye, a review

Hynnekleiv

Magno

Moschowits

et al. 2023

Acta Ophthalmologica

Self Cite

View full text Add to dashboard Cite

Dry eye disease (DED) is a highly prevalent and debilitating condition. Hyaluronic acid (HA) is a naturally occurring glycosaminoglycan that has a long history as a safe and effective DED treatment. HA is frequently used as a comparator when assessing other topical DED treatments. This study aims to summarise and critically evaluate the literature describing all isolated active ingredients that have been directly compared with HA in the treatment of DED. A literature search was conducted in Embase using Ovid on the 24th of August 2021 and in PubMed including MEDLINE on the 20th of September 2021. Twenty‐three studies met the inclusion criteria, 21 of which were randomised controlled trials. Seventeen different ingredients representing six treatment categories were compared with HA treatment. Most measures showed no significant difference between treatments, suggesting either equivalency of treatments or that studies were underpowered. Only two ingredients were represented in more than two studies; carboxymethyl cellulose treatment appears equivalent to HA treatment, while Diquafosol treatment appears superior to HA treatment. Drop‐frequency varied from one to eight drops daily. No single study explained the choice of drop frequency. Nine studies used a HA concentration of 0.1% which may be below therapeutic levels. Nine studies reported using preserved formulations, six of them with differences in preservatives between the compared groups. Thirteen studies were financially linked to industry. No major complications were reported. Studies were not designed to find differences in treatment effects for different types or severities of DED. HA is a good comparator treatment when assessing other DED treatments, although consensus after decades of use is still lacking for best choice of concentration, molecular weight and drop tonicity. Well‐designed studies are needed to determine an evidence‐based standard for HA treatment to be used as comparator.

show abstract

Section: Discussionmentioning

confidence: 99%

A comparison between hyaluronic acid and other single ingredient eye drops for dry eye, a review

Hynnekleiv

Magno

Moschowits

et al. 2023

Acta Ophthalmologica

Self Cite

View full text Add to dashboard Cite

show abstract

“…Fixed combinations have the advantage of no fushing efects between diferent drugs, less total usage frequency, and less damage to the ocular surface, thus improving the patient's compliance in a sense. Te preservatives in topical glaucoma medications are confrmed to exert deleterious efects on the ocular surface with resultant tear flm instability and dry eye disease [14]. Terefore, medications with unit dose package provide preservative-free choices for patients with ocular surface diseases who are less tolerate for ordinary glaucoma drugs.…”

Section: Discussionmentioning

confidence: 99%

Changes of the Types and Daily Costs of Topical Antiglaucoma Medications from 2006 to 2021 in China

Zhang

Jia

Gao

et al. 2023

Journal of Clinical Pharmacy and Therapeutics

View full text Add to dashboard Cite

Purpose. To investigate the changes of the types and daily costs of topical antiglaucoma medications from 2006 to 2021 in China, providing evidence for optimizing treatment regimen and medical insurance policy. Methods. The types of topical antiglaucoma drugs except complementary and traditional medicines and associated price information were collected from the largest pharmaceutical database in China (YAOZH database). The daily costs of each drug, the average income level, and the daily cost of topical antiglaucoma medications relative with daily disposable income were calculated and compared between 2006 and 2021. Results. The options of topical antiglaucoma drugs increased remarkably to 32 types in 2021, of which prostaglandin analogs comprised the largest proportion (31.25%). There were 10 types of the same brand drugs available in 2006 and 2021, the mean daily cost of which decreased from $0.39 ± 0.30 to $0.28 ± 0.23 ( p < 0.001 ). As the average daily disposable income of Chinese residents grew greatly, the proportion of the daily cost of topical antiglaucoma medications in daily disposable income in 2021 declined significantly from 32.52% to 5.78% (all the drugs, p < 0.001 ) and 3.94% (without unit dose package, p < 0.001 ) in rural areas and from 9.95% to 2.31% (all the drugs, p < 0.001 ) and 1.57% (without unit dose package, p < 0.001 ) in urban areas. Conclusions. Topical antiglaucoma medications available become much more abundant in China. With the increase of residents’ disposable income and reduction of daily costs of topical antiglaucoma medications, the drug treatment for glaucoma becomes more affordable both in rural and urban areas.

show abstract

“…1,2 Moreover, different studies demonstrated that excipients and preservatives are primarily implicated as 'drivers' of chronic inflammation of the ocular surface, leading to instability of the precorneal tear film. 3,4 In vivo confocal microscopy showed that squamous metaplasia, inflammatory cell infiltrates (granulocytes, lymphocytes, Langerhans cells), dendritic cell activation, loss of goblet cells and stromal fibrosis are the most often seen changes in the conjunctival and corneal epithelium. 5 Therefore, the role of the ocular surface has become prominent, influencing the tolerability of glaucoma treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Although effective, both preserved and preservative‐free (PF) topical drugs determine conjunctival and corneal microstructure alterations, thus causing poor patient compliance, ocular discomfort, and generally a low QOL 1,2 . Moreover, different studies demonstrated that excipients and preservatives are primarily implicated as ‘drivers’ of chronic inflammation of the ocular surface, leading to instability of the pre‐corneal tear film 3,4 . In vivo confocal microscopy showed that squamous metaplasia, inflammatory cell infiltrates (granulocytes, lymphocytes, Langerhans cells), dendritic cell activation, loss of goblet cells and stromal fibrosis are the most often seen changes in the conjunctival and corneal epithelium 5 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of ocular surface following PreserFlo Microshunt implantation: Functional outcomes and quality of life

Gambini,

Carlà,

Giannuzzi

et al. 2023

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

BackgroundThis study aimed to evaluate the impact of PreserFlo Microshunt on the ocular surface, focusing on both objective and subjective parameters.MethodsProspective‐observational study on 48 eyes undergoing PreserFlo Microshunt implantation, standalone or combined with phacoemulsification. At baseline, 1‐month, 6‐months and 12‐months post‐operative follow‐ups, we performed Ocular Surface Disease Index (OSDI) questionnaire, Schirmer's test (ST), Tear‐film break‐up time (TBUT), fluoresceine staining (FS), tear osmolarity and minimum corneal epithelial thickness (Epi‐ThkMIN.) measurements.ResultsOSDI score improved from 37.43 ± 17.49 at baseline, to 24.13 ± 12.55 at 1‐month (p = 0.003) and to 12.89 ± 8.54 and 13.09 ± 10.22 at 6‐months and 12‐months (p < 0.0001). TBUT and ST, in a similar way, non‐significantly increased at 1‐month, but then improved at 6‐months and 12‐months (p < 0.05 for both). Tear osmolarity significantly decreased from 308.2 ± 7.3 mOsm/L at baseline, to 303.3 ± 8.2 mOsm/L, 295.6.2 ± 7.0 mOsm/L and 297.6 ± 6.8 mOsm/L at 1‐month, 6‐months and 12‐months (p < 0.05 for all). Epi‐ThkMIN was stable when comparing baseline (44.9 ± 5.7 μm) and 1‐month (p = 0.28), and successively increased in 6‐months (47.8 ± 5.5 μm, p = 0.02) and 12‐months (48.0 ± 3.6 μm, p = 0.01). In subgroup analysis, OSDI score and tear osmolarity were significantly higher at 1‐month in combined group compared to standalone group (p = 0.03 and p = 0.02, respectively), but reaching comparable values in successive follow‐ups. Further, Oxford scale grades for FS were significantly improved when comparing baseline–6‐months and baseline–12‐months.ConclusionPreserFlo implantation improved ocular surface subjective symptoms, increased TBUT and ST, and reduced FS, highlighting the potential benefits of this surgical intervention. Moreover, we reported significant improvements of tear osmolarity and corneal epithelium.

show abstract

Topical glaucoma medications – Clinical implications for the ocular surface

Cited by 24 publications

References 243 publications

A comparison between hyaluronic acid and other single ingredient eye drops for dry eye, a review

A comparison between hyaluronic acid and other single ingredient eye drops for dry eye, a review

Changes of the Types and Daily Costs of Topical Antiglaucoma Medications from 2006 to 2021 in China

Evaluation of ocular surface following PreserFlo Microshunt implantation: Functional outcomes and quality of life

Contact Info

Product

Resources

About