June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Topical glaucoma therapy is associated with alterations of the ocular surface microbiome
Author Affiliations & Notes
  • Chih-Chiun Jamie Chang
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
    Ophthalmology, University of California San Francisco School of Medicine, San Francisco, California, United States
  • Karina Somohano
    Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
  • Christine Zemsky
    Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
  • Anne-Catrin Uhlemann
    Internal Medicine - Infectious Diseases, Columbia University Irving Medical Center, New York, New York, United States
  • Jeffrey M Liebmann
    Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
  • George A Cioffi
    Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
  • Lama A Al-Aswad
    Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
  • Susan Lynch
    Division of Gastroenterology, University of California San Francisco Department of Medicine, San Francisco, California, United States
  • Bryan Winn
    Ophthalmology, University of California San Francisco, San Francisco, California, United States
  • Footnotes
    Commercial Relationships   Chih-Chiun Chang None; Karina Somohano None; Christine Zemsky None; Anne-Catrin Uhlemann None; Jeffrey Liebmann None; George Cioffi None; Lama Al-Aswad None; Susan Lynch None; Bryan Winn None
  • Footnotes
    Support  UCSF Vision Shared Resource Core Grant (NIH/NEI P30 EY002162)
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 4272. doi:
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      Chih-Chiun Jamie Chang, Karina Somohano, Christine Zemsky, Anne-Catrin Uhlemann, Jeffrey M Liebmann, George A Cioffi, Lama A Al-Aswad, Susan Lynch, Bryan Winn; Topical glaucoma therapy is associated with alterations of the ocular surface microbiome. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4272.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Preserved topical medications used in the management of glaucoma are associated with ocular surface inflammation. The purpose of this cross-sectional study was to describe the ocular surface microbiome of patients treated with preserved topical ophthalmic medications as compared to that of healthy controls and to determine if microbial community changes were related to measures of ocular surface disease.

Methods : V3-V4 16S rRNA sequencing was conducted on ocular surface swabs collected from both eyes of 17 subjects: 10 patients with asymmetric/unilateral glaucoma using preserved topical glaucoma therapy on only one eye and 7 age-matched, healthy controls with no history of ocular disease or eyedrop use. Air swabs were used as negative controls. Samples were categorized into three groups: patients’ glaucomatous eye treated with eyedrops, patients’ contralateral eye without eyedrops, and healthy control eyes. Comparisons were made for microbial diversity and composition, with differences in composition tested for association with ocular surface disease measures including tear meniscus height (TMH), tear break-up time (TBUT), and Dry Eye Questionnaire scores (DEQ-5). The Columbia University Institutional Review Board approved this study.

Results : Samples obtained from treated and untreated patient eyes both had greater alpha-diversity (Shannon Diversity; Figure 1A, 1C) and distinct microbial composition (Bray Curtis Distance; Figure 1B, 1D) compared to controls. Patient samples had an increased relative abundance of gram-negative organisms dominated by Akkermansia compared to gram-positive commensals in controls (Figure 2). The microbial composition of patient eyes was associated with decreased TMH and TBUT, while metagenomic predictions based on 16S rRNA data suggested increased synthesis of the inflammatory endotoxin lipopolysaccharide.

Conclusions : The ocular surface microbiome of patients taking unilateral preserved glaucoma drops is characterized by a diverse array of gram-negative bacteria that is significantly different from the predominantly gram-positive microbes detected on healthy control eyes. These compositional differences were associated with decreased tear film measures and distinct inferred protein synthesis pathways, suggesting a potential link between microbial alterations and ocular surface inflammation.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

 

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