Purpose:
To evaluate the long-term effects of antiglaucoma eye drops on the density of goblet cells (GCD) on conjunctiva by in vivo laser scanning confocal microscopy (LSCM).
Methods:
A total of 25 patients (10 male, 15 female; mean age, 58.5; range, 45 to 79 years) with bilateral primary open-angle glaucoma treated with timolol maleate 0.5% twice daily and latanoprost 0.05% once daily in both eyes for more than one year and 20 healthy age-matched volunteers were studied. Clinical tests (Schirmer I test, lachrymal film break-up time and corneal fluorescein staining), and in vivo LSCM were performed. SPSS 11.5 software was used to analyze the alteration of GCD after a long-term therapy of antiglaucoma eye drops and the correlation between GCD and each clinical parameter.
Results:
The conjunctival goblet cell in LSCM images was characterized as a large hyperreflective oval-shape cell with relatively homogeneous brightness. The mean GCD was 265±73 (cells/mm2) in the glaucomatous patients, presenting a significant reduction to the control subjects, 426±70 (cells/mm2) (P < .05). A significant decline of the scores was found between groups on topical hypotensive therapy and the control group in all clinical parameters studied (P < .05). No correlation was observed between the GCD and all the clinical scores, except the lachrymal film break-up time (P < .05).
Conclusions:
By in vivo LSCM, the decline of GCD, correlated with the decreasing of lachrymal film break-up time, was identified in patients after a long-term therapy of antiglaucoma eye drops, which might be helpful to understand the pathology of drug-induced dry eye.
Keywords: conjunctiva • cornea: tears/tear film/dry eye • microscopy: confocal/tunneling