Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
Cornea. 2012 Sep;31(9):994-9. doi: 10.1097/ICO.0b013e31823f8cb6.
To evaluate tear film osmolarity in patients treated with intraocular pressure-lowering medications.
Forty patients treated for glaucoma or ocular hypertension (OHT) were consecutively recruited for the study. Each patient was asked to complete an evaluation of ocular surface disease symptoms, the Ocular Surface Disease Index, and underwent a complete evaluation of the ocular surface including measurement of tear film osmolarity, Schirmer test, tear breakup time (TBUT), and corneal and conjunctival staining.
Twenty-four patients (60%) reported ocular surface disease symptoms. Nineteen patients (47.5%) had a tear osmolarity ≤308 mOsms/L, 11 (27.5%) between 309 and 328 mOsms/L, and 10 (25%) >328 mOsms/L. A tear deficiency was observed in 20 patients (50%). Twenty-seven patients (67.5%) had an abnormal tear quality analyzed with TBUT, and 16 patients (40%) showed positive staining using the Oxford schema. Tear osmolarity was significantly correlated to Ocular Surface Disease Index (r = 0.486; P = 0.002) and TBUT (r = -0.49; P = 0.009). There was a statistically significant correlation between tear osmolarity and the number of drugs (r = 0.409; P = 0.009), the number of instillations (r = 0.405; P = 0.01), and the number of instillations of preserved eye drops (r = 0.629; P < 0.0001). Using the multiple regression method, tear osmolarity remained significantly correlated to the number of instillations of preserved eye drops (P = 0.004).
Tear osmolarity was increased in patients treated for glaucoma or OHT, particularly in those using multiple preserved eye drops. The evaluation of the ocular surface of patients treated for glaucoma or OHT may benefit from such analysis, and future trials for new intraocular pressure-lowering eye drops should thus evaluate tear osmolarity.
评估接受降眼压药物治疗的患者的泪膜渗透压。
连续招募了 40 名接受青光眼或高眼压（OHT）治疗的患者进行研究。每位患者都需要完成眼部表面疾病症状评估、眼表面疾病指数（OSDI）评估，并进行全面的眼部评估，包括泪膜渗透压测量、泪液分泌试验、泪膜破裂时间（TBUT）、角膜和结膜染色。
24 名患者（60%）报告有眼部表面疾病症状。19 名患者（47.5%）的泪液渗透压≤308mOsms/L，11 名患者（27.5%）的渗透压在 309 至 328mOsms/L 之间，10 名患者（25%）的渗透压>328mOsms/L。20 名患者（50%）出现泪液缺乏。27 名患者（67.5%）的泪液质量异常，TBUT 分析异常，16 名患者（40%）使用牛津方案出现阳性染色。泪膜渗透压与眼表面疾病指数（OSDI）显著相关（r=0.486；P=0.002），与 TBUT 显著相关（r=-0.49；P=0.009）。泪膜渗透压与药物使用种类（r=0.409；P=0.009）、使用次数（r=0.405；P=0.01）、含防腐剂滴眼剂使用次数（r=0.629；P<0.0001）均呈显著正相关。使用多元回归方法，泪膜渗透压与含防腐剂滴眼剂的使用次数仍显著相关（P=0.004）。
接受青光眼或 OHT 治疗的患者的泪膜渗透压升高，尤其是使用多种含防腐剂滴眼剂的患者。评估接受青光眼或 OHT 治疗的患者的眼表面可能会受益于这种分析，未来的降眼压新滴眼液试验也应该评估泪膜渗透压。
