Itoh Clinic, 626-11 Minaminakano, Minuma-ku, Saitama City, Saitama, 337-0042, Japan.
Graefes Arch Clin Exp Ophthalmol. 2012 Aug;250(8):1181-5. doi: 10.1007/s00417-012-1943-6. Epub 2012 Feb 18.
To examine effects of long-term topical anti-glaucoma medications on meibomian gland morphology and function and assess their relationship with slit-lamp findings.
This was a cross-sectional observational case series of 31 patients with glaucoma (mean age ± standard deviation, 65.0 ± 13.0 years; mean duration of eye drop use, 7.9 ± 6.0 years) treated with topical anti-glaucoma drugs in only one eye for more than 1 year: 13 receiving prostaglandin analogues (PGs) alone, eight receiving β-blockers alone, and ten receiving multiple treatments. Untreated contralateral eyes served as controls. Lid margin (lid margin abnormality score: 0-4) and superficial punctate keratopathy (SPK score: 0-1) were observed with a slit lamp. Upper and lower eyelids were turned over to observe meibomian glands using non-contact meibography. Meibomian gland loss was scored for each eyelid from grade 0 (no loss of meibomian glands) through grade 3 (loss >2/3 of total meibomian gland area). Meibomian lipid content (meibum) was scored (meibum score: 0-3).
Treated eyes had significantly higher scores for lid margin abnormality (P= 0.001), SPK (P< 0.001), meibo-score (P< 0.001), and meibum (P< 0.001) than control eyes. Tear film break-up time (BUT) was significantly shorter in treated eyes than in control eyes (P= 0.001). Schirmer values were significantly lower in treated eyes than in control eyes (P= 0.0039). Subgroup analysis indicated a significantly higher meibo-score in eyes treated with PGs (P= 0.0046) and in eyes treated with β-blockers (P= 0.0231) than in the corresponding controls.
Long-term anti-glaucoma eye drop use affects meibomian gland morphology and function.
研究长期局部抗青光眼药物对睑板腺形态和功能的影响，并评估其与裂隙灯检查结果的关系。
这是一项对 31 例青光眼患者（平均年龄 ± 标准差，65.0 ± 13.0 岁；平均滴眼时间，7.9 ± 6.0 年）的横断面观察性病例系列研究，这些患者在 1 年以上的时间里仅用单眼接受局部抗青光眼药物治疗：13 例使用前列腺素类似物（PGs），8 例使用β受体阻滞剂，10 例使用多种治疗方法。未治疗的对侧眼作为对照。用裂隙灯观察睑缘（睑缘异常评分：0-4）和浅层点状角膜病变（SPK 评分：0-1）。翻上上下眼睑，用非接触式睑板腺照相观察睑板腺。对每只眼睑的睑板腺缺失进行评分，从 0 级（无睑板腺缺失）到 3 级（缺失>2/3的总睑板腺面积）。睑板腺脂质（泪液）评分（泪液评分：0-3）。
治疗眼的睑缘异常评分（P=0.001）、SPK 评分（P<0.001）、meibo 评分（P<0.001）和泪液评分（P<0.001）均显著高于对照组。治疗眼的泪膜破裂时间（BUT）明显短于对照组（P=0.001）。治疗眼的 Schirmer 值明显低于对照组（P=0.0039）。亚组分析表明，PG 治疗眼（P=0.0046）和β受体阻滞剂治疗眼（P=0.0231）的 meibo 评分显著高于相应的对照组。
长期抗青光眼滴眼剂的使用会影响睑板腺的形态和功能。
