Abstract
Purpose: :
To determine whether topical prostaglandins increase the expression of conjunctival inflammatory markers in uveitics and to determine if this is altered by the use of topical steroidsand to extrapolate this information clinicaly into its influence on trabeculectomy blebs in uveitics.
Methods: :
A single visit, non-randomized pilot study of 20 patients divided into four groups of 5 patients each (PG only, ST only, PG and ST, no drops). Conjunctival cells harvested by impression cytology and were examined for inflammatory markers (CD3, CD54, HLA-DR, CCR4, CCR5) by flow cytometry. A tear fluid sample was also examined for inflammatory cytokines (IL-12p70, IL-2, IL-10, IL-8, IL-6, IL-4, IL-5, IFN-gamma, IL-1beta, IFN-alpha, IFN-beta).
Results: :
No statistical difference was found between any of the groups. All groups demonstrated markers of conjunctival inflammation. CD3, CD54, HLA-DR, CCR4, CCR5, IL-12p70, IL-10, IL-6, IL-4, IFN-gamma, IL-1beta, IFN-alpha, were normally distributed and analysis of variance (ANOVA) did not show any statistical difference between groups. IL-2, IL-8, IL-5 and IFN-beta were not normally distributed, were analyzed using Kruskal Wallis Test and did not show any statistical difference between groups either.
Conclusions: :
All uveitis patients examined whether on or off prostaglandin drops had increased inflammatory markers on their conjunctival cells. We can conclude from this pilot study that topical prostaglandins do not increase conjunctival inflammation and this is not modified by topical steroids. Treatment of raised intraocular pressure with topical prostaglandins is therefore not likely to predispose to trabeculectomy failure should trabeculectomy become necessary in the future.
Keywords: uveitis-clinical/animal model • conjunctiva • inflammation