Abstract
Purpose :
Previous studies have determined that a high percentage of glaucoma treated patients present dry eye symptoms The aim of this study is to evaluate the damage of anti-glaucoma eye drops on the ocular surface through the alteration of specific ocular surface markers.
Methods :
Forty-four patients (21 men and 23 women) were included in this study. Eleven eyes without any glaucoma treatment were included in the control group, 21 eyes treated with different anti-glaucomatous drops formed the treated group and 12 eyes with glaucoma surgery belonged to the operated group without using hypotensive drops. The patient mean age was 70.52 and there were no statistical differences between the groups. We performed impression cytology in both eyes. We used by real-time PCR to measure the expression of several genes implicated in ocular surface damage including inflammation (IL6, IL8, TGFb2, HLA-DR1), mucins production (MUC1, MUC5AC) and protective factors (TFF1).
Results :
Ocular surface analysis showed no comparative differences in Goblet (GB) cell density in any of the three groups unlike in the case of dry eye patients. In this sense, analysis of genes expression showed a significant increase in MUC5AC (P=0.036), and TFF1 (P=0.021) produced by GB cells in treated patients compare to controls or operated patients. Ocular inflammation markers, TGFb2 (P=0071) and IL8 (P=0.0003) were also elevated in the conjunctival ephitelium of treated patients compared to those without treatment. Among treated patients, besides MUC5AC (P=0.005) and TFF1 (P=0.012), TGFb2 was significantly higher in those exposed to preservatives in the topical drugs (P<0.0001) compared to no preserved drug associated with drug users.
Conclusions :
A high percentage of glaucoma patients display clinical symptoms associated with dry eyes. The initial cause of the symptoms does not seem to be a decrease of GB cells nor mucin production. The causal symptoms could be the inflammatory response detected by an increase of inflammatory markers such as IL8 or TGFb2, the latter is highly associated with the preservatives present in glaucoma medication. To investigate the mediators of the damage in the ocular surface associated with the use of glaucoma drops will help to manage the discomfort suffered by a great number of glaucoma patients.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.