Symptoms and signs of ocular surface disease related to topical medication in patients with glaucoma

Barbara Cvenkel,1 Špela Štunf,1 Irena Srebotnik Kirbiš,2 Margareta Strojan Fležar2 1Department of Ophthalmology, University Medical Center Ljubljana, Ljubljana, Slovenia; 2Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia Pu...

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Autores principales: Cvenkel B, Štunf Š, Srebotnik Kirbiš I, Strojan Fležar M
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Publicado: Dove Medical Press 2015
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spelling oai:doaj.org-article:5b61bd9758d740d6becbfed39b9651d12021-12-02T00:46:05ZSymptoms and signs of ocular surface disease related to topical medication in patients with glaucoma1177-5483https://doaj.org/article/5b61bd9758d740d6becbfed39b9651d12015-04-01T00:00:00Zhttp://www.dovepress.com/symptoms-and-signs-of-ocular-surface-disease-related-to-topical-medica-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483 Barbara Cvenkel,1 Špela Štunf,1 Irena Srebotnik Kirbiš,2 Margareta Strojan Fležar2 1Department of Ophthalmology, University Medical Center Ljubljana, Ljubljana, Slovenia; 2Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia Purpose: The aim of this study was to assess signs and symptoms of ocular surface disease (OSD) and the cytomorphological changes of ocular surface in glaucoma patients using preserved antiglaucoma drops.Methods: In this cross-sectional study, 109 participants (79 patients with topical medication and 30 untreated controls) completed the Ocular Surface Diseases Index (OSDI) questionnaire and underwent an ophthalmic examination, including Schirmer test, tear film breakup time (TBUT), and fluorescein staining. Conjunctival specimens were collected by impression cytology and analyzed by light microscopy using Nelson’s grading scheme (grades 0–3). This classification is based on the nucleus-to-cytoplasm ratios of epithelial cells and the numbers of goblet cells, with grade 2 considered abnormal.Results: The medication group had significantly shorter TBUT (median [interquartile range]: 6.0 seconds [5.0–8.0 seconds] vs 9.5 seconds [6.0–12.3 seconds]; P<0.03), greater fluorescein staining (1.0 [0.75–1.25] vs 0 [0–0.25]; P<0.001), and higher impression cytology grade than the control group (median [range]: 1.0 [1:2 to 1:6] vs 0.6 [1:2 to 1:4]; P<0.001). The increasing number of drops instilled per day was associated with an increase in fluorescein staining (Spearman’s rho r=0.475; P<0.001) and shorter TBUT (r=-0.278; P=0.014). The OSDI did not discriminate between the two groups.Conclusion: Clinical tests and impression cytology showed ocular surface damage in patients using preserved antiglaucoma medications. However, there was no statistically and clinically significant difference in symptoms measured by OSDI score between the medication and control groups. Keywords: ocular surface disease, dry eye diagnostic tests, ocular surface disease index questionnaire, impression cytology, topical glaucoma medicationCvenkel BŠtunf ŠSrebotnik Kirbiš IStrojan Fležar MDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2015, Iss default, Pp 625-631 (2015)
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
Cvenkel B
Štunf Š
Srebotnik Kirbiš I
Strojan Fležar M
Symptoms and signs of ocular surface disease related to topical medication in patients with glaucoma
description Barbara Cvenkel,1 Špela Štunf,1 Irena Srebotnik Kirbiš,2 Margareta Strojan Fležar2 1Department of Ophthalmology, University Medical Center Ljubljana, Ljubljana, Slovenia; 2Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia Purpose: The aim of this study was to assess signs and symptoms of ocular surface disease (OSD) and the cytomorphological changes of ocular surface in glaucoma patients using preserved antiglaucoma drops.Methods: In this cross-sectional study, 109 participants (79 patients with topical medication and 30 untreated controls) completed the Ocular Surface Diseases Index (OSDI) questionnaire and underwent an ophthalmic examination, including Schirmer test, tear film breakup time (TBUT), and fluorescein staining. Conjunctival specimens were collected by impression cytology and analyzed by light microscopy using Nelson’s grading scheme (grades 0–3). This classification is based on the nucleus-to-cytoplasm ratios of epithelial cells and the numbers of goblet cells, with grade 2 considered abnormal.Results: The medication group had significantly shorter TBUT (median [interquartile range]: 6.0 seconds [5.0–8.0 seconds] vs 9.5 seconds [6.0–12.3 seconds]; P<0.03), greater fluorescein staining (1.0 [0.75–1.25] vs 0 [0–0.25]; P<0.001), and higher impression cytology grade than the control group (median [range]: 1.0 [1:2 to 1:6] vs 0.6 [1:2 to 1:4]; P<0.001). The increasing number of drops instilled per day was associated with an increase in fluorescein staining (Spearman’s rho r=0.475; P<0.001) and shorter TBUT (r=-0.278; P=0.014). The OSDI did not discriminate between the two groups.Conclusion: Clinical tests and impression cytology showed ocular surface damage in patients using preserved antiglaucoma medications. However, there was no statistically and clinically significant difference in symptoms measured by OSDI score between the medication and control groups. Keywords: ocular surface disease, dry eye diagnostic tests, ocular surface disease index questionnaire, impression cytology, topical glaucoma medication
format article
author Cvenkel B
Štunf Š
Srebotnik Kirbiš I
Strojan Fležar M
author_facet Cvenkel B
Štunf Š
Srebotnik Kirbiš I
Strojan Fležar M
author_sort Cvenkel B
title Symptoms and signs of ocular surface disease related to topical medication in patients with glaucoma
title_short Symptoms and signs of ocular surface disease related to topical medication in patients with glaucoma
title_full Symptoms and signs of ocular surface disease related to topical medication in patients with glaucoma
title_fullStr Symptoms and signs of ocular surface disease related to topical medication in patients with glaucoma
title_full_unstemmed Symptoms and signs of ocular surface disease related to topical medication in patients with glaucoma
title_sort symptoms and signs of ocular surface disease related to topical medication in patients with glaucoma
publisher Dove Medical Press
publishDate 2015
url https://doaj.org/article/5b61bd9758d740d6becbfed39b9651d1
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