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Francesca Berardo, Manuela Ferrazza, Gloria Roberti, Luca Agnifili, Lucia Tanga, Gianluca Manni, Michele Figus, Manuele Michelessi, Francesco Oddone; Exploring the effects of an ophthalmic solution containing high concentration hyaluronic acid (0.4%) and taurine 0.5% on the ocular surface of glaucoma patients under topical hypotensive therapy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5174.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma patients (GLP) under preserved topical hypotensive therapy are at increased risk of reduced number of goblet cells (GC) and dry eye. Hyaluronic acid (HA) eye drops have been found to be effective in the treatment of dry eye. Taurine (TAU) is an aminonacid with osmoprotectant and antioxidant properties. The aim of this pilot, randomized, prospective, parallel study was to evaluate the effect of an ophthalmic solution containing HA 0.4% and TAU 0.5% (Oftaial Plus, Alfaintes srl) on ocular surface signs, symptoms and morphological parameters in GLP under chronic preserved hypotensive eye drops.
Twenty-eight GLP were included in this study. A complete ophthalmological examination was performed at baseline including Shirmer I and tear break-up time (BUT) tests and conjunctival confocal laser microscopy with the Rostock Cornea Module of the HRT3 (Heidelbergh Engineering, Germany). GLP were asked to fill the Ocular Surface Disease Index (OSDI) and Glaucoma Symptoms Score (GSS) questionnaires. GLP were then randomized to use either Oftaial Plus QID (G1) or an ophthalmic solution of hyaluronic acid 0.2% QID (G2) in both eyes and were followed-up at 30 and 90 days. Multivariate analysis of variance for repeated measures and Dunnet post-hoc test were used to analyze between and within groups changes throughout the follow-up.
At baseline all the parameters were similar between G1 and G2: Shirmer test, (p=0.87), BUT (p=0.13), OSDI (p=0.31), GSS (p=0.28), GC (p=0.52).Changes over time of GC, BUT, but not of Shirmer test, GSS and OSDI, were statistically different between groups (p=0.01 and p<0.001, p=0.19, p=0.28 and p=0.89).GC and BUT significantly improved at 90 days from baseline in G1 (+20.4±32.6 cells, p=0.035 and +5.6±2.6 sec, p<0.0001) but not in G2 (+0.8±2.9 cells, p=0.033 and +0.9±2.0 sec, p=0.10). A trend of improved GSS score was observed at 90 days in G1 (+8.5±15.4, p=0.06) but not in G2 (+2.1±6.1, p=0.2). No significant changes of OSDI score were observed at 90 days in either groups.
The use of an ophthalmic solution containing HA at high concentration (0.4%) and TAU 0.5% in GLP under chronic preserved hypotensive topical therapy seems to be associated with an increase of conjunctival goblet cells number and with an improvement of BUT and dry eye symptoms.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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