University Eye Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
J Ocul Pharmacol Ther. 2013 May;29(4):390-4. doi: 10.1089/jop.2011.0159. Epub 2012 Dec 7.
To record signs and symptoms of ocular surface disease (OSD) in patients treated with Intra Ocular Pressure (IOP)-lowering medications; to evaluate the relationship between signs and symptoms; and to identify how to diagnose and follow OSD and its impact on the quality of life in such patients.
A prospective observational study of enrolled consecutive topically treated open-angle glaucoma or ocular hypertension patients: patients presenting systemic or ocular conditions that could interfere with ocular surface status were excluded. Enrolled patients underwent a complete ophthalmic examination comprehensive of evaluation of tear film break-up time (TF-BUT) and fluorescein corneal staining (keratitis punctatae) and who completed the Italian version of both the National Eye Institute-Visual Function Questionnaire (NEI-VFQ) 25 and the Glaucoma Symptom Scale (GSS) questionnaires.
233 patients adhered to a study protocol. Punctatae keratitis was detected in 70 (30%) eyes; abnormal TF-BUT in 67 (28.8%) patients: 97 patients (42.1%) presented an OSD. The abnormal values were gender-independent, keratitis was statistically related to age (P=0.01) and number of instillations/die (P=0.0007). TF-BUT was related to the IOP value (P<0.0001). The NEI ocular pain subscale was statistically related to TF-BUT (P=0.017); GSS was both related to TF-BUT and punctatae keratitis (P<0.00001).
Many patients present an OSD related to therapy, and this affects their quality of life. The use of fixed combinations to reduce surface exposition and of benzalkonium chloride-free formulations should be encouraged to reduce and contain the onset or worsening of this secondary condition in glaucoma patients. The GSS has shown a good relation to signs and should be routinely used to evaluate the impact of OSD on the quality of life.
记录接受降眼压药物治疗的患者的眼表疾病（OSD）的体征和症状；评估体征和症状之间的关系；并确定如何诊断和随访 OSD 及其对这些患者生活质量的影响。
一项对局部治疗的开角型青光眼或高眼压症患者进行的前瞻性观察性研究：排除有全身性或眼部疾病可能影响眼表状况的患者。入组患者接受全面的眼科检查，包括泪膜破裂时间（TF-BUT）和荧光素角膜染色（点状角膜炎）评估，并完成意大利语版国家眼科研究所视觉功能问卷（NEI-VFQ）25 和青光眼症状量表（GSS）问卷。
233 例患者符合研究方案。70 只眼（30%）出现点状角膜炎；67 例（28.8%）患者的 TF-BUT 异常：97 例（42.1%）患者存在 OSD。异常值与性别无关，角膜炎与年龄（P=0.01）和滴数/天（P=0.0007）呈统计学相关。TF-BUT 与眼压值相关（P<0.0001）。NEI 眼部疼痛子量表与 TF-BUT 呈统计学相关（P=0.017）；GSS 与 TF-BUT 和点状角膜炎均相关（P<0.00001）。
许多患者存在与治疗相关的 OSD，这会影响他们的生活质量。应鼓励使用固定组合以减少表面暴露，并使用不含苯扎氯铵的制剂，以减少和控制青光眼患者中这种继发性疾病的发生或恶化。GSS 与体征有很好的相关性，应常规用于评估 OSD 对生活质量的影响。
