ABSTRACT
Aim: The aim of this study was to evaluate the clinical, socio‑economic, and demographic factors associated with the severity at presentation among juvenile primary open angle glaucoma (JOAG) patients. Materials and Methods: Age at diagnosis, family history, baseline intraocular pressure (IOP), access to health‑care, socio‑economic status, and glaucoma awareness among 80 unrelated JOAG patients presenting between 10 years and 40 years of age were analyzed for their association with the severity at presentation. Severity at presentation was graded based on worse eye visual field using the advanced glaucoma intervention study score and on binocular visual field defects at presentation. Results: Patients with a positive family history presented 4 years earlier (P = 0.045, confidence interval [CI]: 0.09‑8.8) compared to those without a family history. Lower socio‑economic status (Odds ratio [OR] 5.7, P = 0.01, CI: 1.5‑22), and higher baseline IOP (OR 7, P = 0.003, CI: 1.9‑26) were associated with severe glaucomatous visual field defect at presentation. A negative family history was associated with a 10 times likelihood of presenting with a severe glaucomatous field defect (OR 0.1, P = 0.007, CI: 0‑0.5). Conclusions: Clinical, socio‑economic, and demographic factors are contributory to the severity at presentation among young patients with early onset glaucoma. Presence of a family history is associated with an earlier presentation among these patients and a reduced risk of the severe presentation
ABSTRACT
PURPOSE: Tear film can be altered by chronic medications that may disrupt the equilibrium responsible for the functioning of the lacrimal gland and ocular surface. The purpose of this study was to determine if antiglaucomatous chronic treatment induced alterations in the tear film and ocular surface. METHODS: After informed consent, 21 patients using antiglaucomatous eye drops for more than 8 months and 20 age- and sex-matched volunteers without eye and systemic medications (control group) were enrolled. The data of ocular discomfort, fluorescein and lisamine green staining, tear film break-up time and Schirmer test were collected and compared by Student's t test. The impression cytology data were graded and compared by chi-square test. RESULTS: Patients chronically using antiglaucomatous medications presented with significant higher fluorescein staining (p=0.003), lisamine green staining (p=0.02) and lower TFBUT (p=0.001). The other comparedparameters, including impression cytology were similar between the treated and control group (p>0.05). CONCLUSIONS: The present study shows that the tear film and the ocular surface are altered in patients under antiglaucomatous medications. In common, all medications were preserved with benzalkonium chloride. Efforts to minimize the adverse effects of chronic use of antiglaucomatous drugs must be addressed.
OBJETIVO: O filme lacrimal pode ser alterado por medicações crônicas, que podem comprometer o equilíbrio responsável pela função da glândula lacrimal e da superfície ocular. O objetivo desse estudo foi determinar se o tratamento crônico com drogas antiglaucomatosas induz alterações no filme lacrimal e superfície ocular. MÉTODOS: Após o consentimento informado, 21 pacientes usando drogas antiglaucomatosas por mais de 8 meses e 20 voluntários com similar distribuição etária e por sexo, não usuários de medicação ocular ou sistêmica (grupo controle) foram incluídos. Os dados do desconforto ocular, coloração com fluoresceína e lissamina verde, tempo de ruptura do filme lacrimal e teste de Schirmer foram colhidos e analisados pelo teste t de Student. A citologia de impressão foi avaliada e comparada pelo teste de qui-quadrado. RESULTADOS: Pacientes usando cronicamente medicação antiglaucomatosa apresentaram ignificativamente maior coloração por fluoresceína (p=0,003), lissamina verde (p=0,02) e menor TRFL (p=0,001). Os outros parâmetros comparados, incluindo a citologia de impressão foram similares entre o grupo tratado e controle (p>0,05). CONCLUSÕES: Esse estudo demonstra que o filme lacrimal e a superfície ocular estão alterados em usuários de medicação antiglaucomatosa. Essas medicações apresentam em comum o cloreto de benzalcônio como conservante. Esforços para minimizar efeitos adversos do uso crônico de drogas antiglaucomatosas devem ser considerados.