The Association of Ocular Surface Disease with Quality of Life in Patients with Glaucoma

Abstract

Purpose : Different studies have shown that the presence of ocular surface disease (OSD) in patients with glaucoma affects patients' quality of life (QoL) and may influence the treatment. In this context, the purpose of this study was to evaluate the association of OSD and QoL in patients with glaucoma who used topical intraocular pressure-lowering therapies.

Methods : This was a prospective cross-sectional study including 9 glaucoma patients and 8 subjects with cataract (control group). Only glaucoma patients who were using at least 1 topical intraocular pressure-lowering medication were included. A detailed ophthalmological examination was performed on each subject. OSD was evaluated using tear break-up time (TBUT), corneal fluorescein staining (conjunctival hyperemia), biomicroscopy showing presence or absence of keratitis, and the Ocular Surface Disease Index (OSDI) questionnaire. OSDI scores higher than 13 indicated a clinically relevant presence of OSD. All patients underwent to non-invasive keratograph BUT, meibography quantification, tear meniscus height, and redness scale. The impact of glaucoma on QoL was investigated using the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the correlations of OSD and the QoL score were investigated.

Results : Mean age was similar in the cataract and glaucoma group (69.25±5.63 vs. 65.00±12.64 years, respectively; P=0.663). Visual acuity of the better and worse eye was similar in both groups (P=0.377 and P=0.340; respectively). There was no significant difference between socioeconomic and commodities index for control and glaucoma groups (P>0.05 for all comparisons). There was a significant difference for OSD: conjunctival hyperemia, and keratitis were worse in glaucoma group (P= 0.005 and P=0.007; respectively). There was a significant relationship between presence of keratitis and QoL scores, even adjusting for socio-economic and clinical parameters (R²= 25%; P<0.027). There was no significant relationship between keratograph parameters and QoL scores (P>0.05 for all comparisons).

Conclusions : Patients with glaucoma had more ocular surface disease measured by clinical evaluation. However, the only parameter associated with worse QoL was the presence of keratitis. The OSD may impact in QoL of patients with glaucoma.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.