ABSTRACT
Glaucoma is a chronic optic neuropathy that affects the retinal ganglion cells, characterized by optic disc atrophy, visual field defects, and visual acuity loss. Since glaucoma is a chronic disease, long-term use of topical intraocular pressure-lowering medications often leads to ocular surface diseases, thus reducing medication adherence and ultimately affecting treatment efficacy. Currently, topical intraocular pressure-lowering medications include prostaglandin derivatives, β-adrenergic blockers, α-adrenergic agonists, topical carbonic anhydrase inhibitors, and cholinergic drugs. This article provides a comprehensive review of the effects and related mechanisms of these five antiglaucoma medications on the ocular surface of glaucoma patients and offers preventative measures for the protection of ocular surface in glaucoma patients.
ABSTRACT
Purpose: To investigate the rate of secondary glaucoma after intravitreal (IV) dexamethasone implant (ozurdex) 0.7 mg injection in a retinal disorder over a clinical treatment period of 2 years in a tertiary eye care center. Methods: Retrospective study based on the records of patients receiving IV ozurdex 0.7 mg implant for T/t of cystoid macular edema (CME), diabetic macular edema (DME), macular edema due to central retinal vein occlusion/branch retinal vein occlusion (CRVO/BRVO), and choroidal neovascular membrane (CNVM) at a tertiary eye care hospital for 2 years with 6 months of follow?up. The post?T/t intraocular pressure (IOP) and antiglaucoma medication (AGM) required was recorded at day 1, 1 week, 1, 2, 3, 4, and 6 months and analyzed for secondary IOP spike or ocular hypertension defined as IOP >21 mmHg at any point in time. The patients with pre?existing glaucoma and lost to follow?up were excluded. Results: A total of 102 eyes of 80 patients were included in the study. The mean baseline IOP was 14.40 + 2.97 mmHg, post?injection was 15.01 + 3.22 mmHg at day 1, 15.15 + 3.28 mmHg at 1 week, 15.96 + 3.62 mmHg at 1 month, 16.26 + 3.95 mmHg at 2 months, 15.41 + 3.33 mmHg at 3 months, 15.38 + 3.28 mmHg at 4 months, and 14.27 + 2.69 mmHg at 6 months. No significant difference was seen from baseline IOP at day 1 (P = 0.163), 1 week (P = 0.086), and 6 months (P = 0.748). Statistically significant difference was seen at 1 month (P = 0.0009), 2 months (P = 0.0001), 3 months (P = 0.023), and 4 months (P = 0.026). The mean IOP peak at 2 months recovered to baseline by 6 months subgroup IOP trend shows a similar variation and the results are consistent with the studies in the literature. About 19/102 (18.62%) eyes showed an IOP spike post?T/t. The maximum was seen at 2 months; 16 eyes showed a rise in the range 22–25 mmHg; 8 in the range 26–30 mmHg; and 1 eye had 34 mmHg and required multiple AGM—no surgical intervention was needed. Conclusion: A secondary IOP spike post?IV ozurdex 0.7 mg seen in 18.62% of the cases require AGM. The IOP monitoring should be meticulously performed for the variations and secondary IOP spike management to prevent irreversible damage to the optic nerve and visual field
ABSTRACT
PURPOSE: This study was conducted to understand the eye drop application method in patients with glaucoma. METHODS: A survey was performed in 5 hospitals on patients diagnosed with glaucoma using eye drops for more than 1 month. Variables associated with eye drop application such as pressing on a dacryocyst after application, time interval between multiple eye drop medications, hygienic management of an eye dropper and shaking a bottle of eye drops before use were evaluated. RESULTS: A total of 581 patients were surveyed in the present study. Regarding pressing on a dacryocyst after applying eye drops, 58 (10%) patients responded always, 103 patients (18%) sometimes, and 409 patients (70%) never. Three hundred fifteen patients (54%) did not touch the eye dropper to their eyes, 190 patients (33%) always shook the eye drop bottle before use and 106 patients (18%) shook the bottle sometimes. CONCLUSIONS: When using eye drops for glaucoma to reduce the intraocular pressure, most patients are committing errors, reducing the effect of treatment and likely causing side effects. When prescribing eye drops to glaucoma patients, the physician should educate patients on the proper method of application.
Subject(s)
Humans , Eye , Glaucoma , Intraocular Pressure , Ophthalmic SolutionsABSTRACT
We assessed quantitatively conjunctival biopsy specimens from 48 primary open angle glaucoma patients[62 eyes]undergoing filtration surgery by light microscopy. The patients were subdivided depending on age, sex, and their therapeutic regimen and duration before surgery. With age, there was a significant increase in lymphocytes and macrophages within the substantia propria of conjunctiva[p<0.05]. The longer the total treatment duration with topical antiglaucoma medication was, the higher the number of lymphocytes and macrophages were[p<0.05]. Whereas, when the treatment duration was adjusted, there was no significant difference between the single therapeutic regimen group and the multiple regimen group. There were some differences in the number of fibroblasts, lymphocytes and macrophages between the group that needed postoperative-antiglaucoma medication[surgical failure group]and the group without postoperative-antiglaucoma medication[surgical success group]but there were no statistically significant differences. In conclusion, administration of topical medication induced a significant degree of subclinical inflammation and change of conjunctival cell profile. However it did not depend on multiple drug regimen but on total treatment duration.