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Renata Portela, Nikoly Tigani Tigani, Denise Freitas, Augusto Paranhos, Tiago S Prata, Carolina Pelegrini Gracitelli; Evaluation of Ocular Surface Disease in Patients with Glaucoma: Clinical parameters, Self-report assessment and Keratograph Analysis.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5889.
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To assess the ocular surface disease (OSD) in patients with glaucoma who used topical intraocular pressure-lowering therapies and to compare with a group of patients with cataract who were not using topical intraocular pressure-lowering therapies.
A total of 15 glaucoma patients and 12 subjects with cataract (control group) were enrolled in the study. Only glaucoma patients who were using at least 1 topical IOP-lowering medication were included. An ophthalmological examination was performed using tear break-up time (TBUT), conjunctival hyperemia and 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 keratograph analysis: non-invasive keratograph BUT, meibography quantification, tear meniscus height, and redness scale. The comparison of OSD between the two groups was assessed.
There was a significant difference for OSD: conjunctival hyperemia and keratitis were worse in glaucoma group (P= 0.011 and P=0.031; respectively). According to OSDI questionnaire, the overall OSD prevalence rate was 44% vs 56% in the cataract and glaucoma group, respectively (P=0.031), and glaucoma group had significant worse scores in the OSDI questionnaire (9.17±2.49 vs. 16.33±2.06; P=0.035). For the keratograph assessment, glaucoma group had significant higher redness compared to cataract group (2.26±0.49 vs. 1.71±0.13, respectively; P=0.009); worse non-invasive BUT (10.19±6.93 vs. 16.81±7.50, respectively; P=0.036); and a smaller tear meniscus height (0.22±0.05 vs. 0.26±0.03, respectively; P=0.031). There was a significant relationship between conjunctival hyperemia (R2= 46%; P=0.029) and keratitis (R2= 16%; P<0.001) and number of medications, even adjusting for socio-economic and clinical parameters.
There is a significant difference between conjunctival hyperemia, presence of keratitis and total scores in OSDI questionnaire in glaucoma group compared to cataract subjects. In addition, in the objective parameters measured by keratograph, glaucoma patients had worse BUT, redness and tear meniscus height. These findings indicate that patients with glaucoma may have significant clinical symptoms for OSD and these are related with the treatment. Awareness of the importance of OSD prevalence in glaucoma patients should not be overlooked.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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