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Alfonso Luis Sabater, Anne-Marie Bleau, Adriano Guarnieri, Vanesa Antón, Gema Rebolleda, Javier Moreno-Montanes; Quantitative measurement of conjunctival hyperemia and tear film properties in glaucoma patients using the Keratograph 5M.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3053.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the effect of ocular hypotensive drops on conjunctival hyperemia and tear film properties in glaucoma patients using the Keratograph 5M (Oculus).
The conjunctival hyperemia (CH) and non-invasive break-up time (NIBUT) in 200 glaucoma patients and 60 patients after glaucomatous filtration surgery (without other topical eye-drops) were quantitatively measured and compared to 50 control patients. Only one eye of each patient was included. In addition, we determined the corneal localization of tear film rupture. We analyzed other parameters: the OSDI score, the number of antiglaucomatous drugs, the number of eye drops administrated per day and the total time of glaucomatous treatment. These parameters were compared with CH and NIBUT using non-parametric statistical test.
The mean (SD) CH was 1.69 (0.59) in glaucomatous eyes, 1.49 (0.48) in operated eyes and 1.39 (0.38) in normal eyes (p<0.05). In glaucomatous eyes, the CH was related to the number of medication administrated (p=0.031). CH returned to normal values after glaucoma surgery (p<0.05). OSDI scores were higher in glaucomatous patients as compared to control patients (p<0.05), and remained elevated in the operated group. In all patients, OSDI score correlated with CH levels (p<0.05).<br /> The mean (SD) NIBUT was 7.30 (5.45) in glaucomatous group, 8.38 (6.68) in operated eyes and 11.03 (6.99) in control group (p<0.05). NIBUT values were significantly lower in the glaucoma surgery group compared to control group (p=0.041). The tear breakup location was in the inferior and nasal corneal area with a mean value of 8.31 (1.11) sec in the treated group, and was in the temporal area with 13.72 (1.54) sec in the control group (p<0.01).
The HC was higher in glaucomatous eyes than in normal and operated group, indicating the irritating effect of the medication on the ocular surface. The correlation between CH and OSDI score confirms a greater discomfort associated with hyperemia. The NIBUT was affected in glaucoma patients, especially in the treated group. The localization of the ocular tear-film rupture was in the inferior area, similar to that found in the dry-eye disease.
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