Kocabeyoglu Sibel, Mocan Mehmet C, Irkec Murat, Orhan Mehmet, Karakaya Jale
Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey.
J Glaucoma. 2014 Jun-Jul;23(5):333-6. doi: 10.1097/IJG.0b013e3182741f32.
To evaluate the impact of conjunctivochalasis (CCh) and its severity on the ocular surface parameters of glaucoma subjects treated with topical antiglaucomatous medication.
One hundred patients with the clinical diagnosis of glaucoma were recruited for this study. CCh was graded based on the extent of inferior lid margin involvement as follows: 1=single (temporal) location, 2=two locations (nasal and temporal), and 3=whole lid. For all the subjects, the break-up time (BUT), lissamine green (LG) staining, and Schirmer test (under topical anesthesia) was performed for both eyes. Ocular Surface Disease Index (OSDI) questionnaire scores were also noted for each subject. Student t test, Mann-Whitney U test, and Kruskal-Wallis test was used for statistical evaluations.
Sixty-three subjects had evidence of CCh; 32 had grade 1, 24 had grade 2, 7 had grade 3 CCh, and 37 glaucoma patients had no evidence of CCh. There were significant differences in the BUT scores (7.2±2.7 vs. 10.1±2.4 s, P<0.001), Schirmer values (7.7±3.9 vs. 13.3.±4.0 mm, P<0.001), LG staining score (1.6±1.0 vs. 0.3±0.5, P<0.001), and the OSDI scores (19.4±17.2 vs. 6.7±5.2, P<0.001) between patients who had CCh and those without CCh. The BUT scores and Schirmer test values of patients with grades 2 and 3 CCh were significantly lower than those of grade 1 CCh and those without CCh (P<0.001). The LG grading and OSDI scores were significantly higher in grade 2 and 3 patients as compared with those with grade 1 CCh and those without CCh (P<0.001).
The functional characteristics of the ocular surface appear to be adversely influenced by the presence and the extent of CCh in glaucoma patients.
评估结膜松弛症（CCh）及其严重程度对局部使用抗青光眼药物治疗的青光眼患者眼表参数的影响。
本研究招募了100例临床诊断为青光眼的患者。根据下睑缘受累程度对CCh进行分级，如下：1级=单个（颞侧）部位，2级=两个部位（鼻侧和颞侧），3级=整个眼睑。对所有受试者的双眼进行泪膜破裂时间（BUT）、丽丝胺绿（LG）染色和泪液分泌试验（表面麻醉下）。还记录了每个受试者的眼表疾病指数（OSDI）问卷得分。采用学生t检验、曼-惠特尼U检验和克鲁斯卡尔-沃利斯检验进行统计学评估。
63例受试者有CCh证据；32例为1级，24例为2级，7例为3级CCh，37例青光眼患者无CCh证据。有CCh和无CCh的患者在BUT得分（7.2±2.7秒对10.1±2.4秒，P<0.001）、泪液分泌试验值（7.7±3.9毫米对13.3±4.0毫米，P<0.001）、LG染色评分（1.6±1.0对0.3±0.5，P<0.001）和OSDI得分（19.4±17.2对6.7±5.2，P<0.001）方面存在显著差异。2级和3级CCh患者的BUT得分和泪液分泌试验值显著低于1级CCh患者和无CCh患者（P<0.001）。与1级CCh患者和无CCh患者相比，2级和3级患者的LG分级和OSDI得分显著更高（P<0.001）。
青光眼患者中CCh的存在及其程度似乎会对眼表的功能特征产生不利影响。
