眼结合膜杯状细胞密度和无防腐剂他氟前列素治疗青光眼：体内共聚焦显微镜和印迹细胞学研究。

Conjunctival goblet cells density and preservative-free tafluprost therapy for glaucoma: an in vivo confocal microscopy and impression cytology study.

机构信息

Department of Medicine and Ageing Science, Ophthalmic Clinic, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.

出版信息

Acta Ophthalmol. 2013 Aug;91(5):e397-405. doi: 10.1111/aos.12131. Epub 2013 Apr 20.

DOI:10.1111/aos.12131

PMID:23601909

Abstract

PURPOSE

To evaluate the density of conjunctival goblet cells (GCs) in glaucomatous patients treated with preservative-free (PF) tafluprost, using laser scanning confocal microscopy (LSCM) and impression cytology (IC).

METHODS

Thirty glaucomatous patients (30 eyes) naive for therapy and thirty healthy subjects (30 eyes) were enrolled. Conjunctiva was examined by means of Heidelberg Retina Tomography/Rostock cornea module. Afterwards, the specimens for IC were obtained. Patients were randomized to PF-tafluprost (Group 1) or preserved latanoprost (Group 2) and controls to the vehicle of latanoprost (Group 3) or physiological buffered saline solution (Group 4). Both LSCM and IC were performed at baseline, and after the 1st and 6th months of therapy, GC density (GCD) (cells/mm(2) ) was the main outcome measurement.

RESULTS

Baseline. Mean GCD was 240.69 ± 25.43 and 232.65 ± 23.52, for LSCM, and 162.10 ± 23.44 and 164.71 ± 21.03 for IC in Group 1 and 2, respectively. GC density values were not significantly different in Group 3 and 4 (p > 0.05%). Month one. Mean GCD increased to 284.16 ± 43.88 and 230.62 ± 48.32 in Group 1 (p < 0.001) and to 297.86 ± 26.87 and 221.78 ± 43.02 in Group 2 (p < 0.05), measured with LSCM and IC, respectively. In Group 3, GCD decreased to 205.88 ± 25.04 and 139.54 ± 17.37 measured with LSCM and IC, respectively (p < 0.05). Month six. Mean GCD did not change in Group 1 (p > 0.05) whereas it decreased in Group 2 (p < 0.05), compared to month 1. In Group 3, GCD further decreased to 166.32 ± 22.31 and 120.76 ± 11.66, measured with LSCM and IC, respectively (p < 0.05); in Group 4, mean GCD did not change during the study period (p > 0.05).

CONCLUSIONS

Treatment with PF tafluprost was associated with an increase in conjunctival GCD in glaucomatous eyes naïve for therapy. Further studies are mandatory to verify this finding because its validation may have important consequences in the medical management of glaucoma.

摘要

目的

使用激光共聚焦显微镜（LSCM）和印迹细胞学（IC）评估无防腐剂（PF）他氟前列素治疗的青光眼患者的结膜杯状细胞（GC）密度。

方法

纳入 30 名初治青光眼患者（30 只眼）和 30 名健康对照者（30 只眼）。使用海德堡视网膜断层扫描仪/罗斯托克角膜模块进行检查。然后，获取用于 IC 的标本。患者随机分为 PF-他氟前列素（第 1 组）或含防腐剂拉坦前列素（第 2 组），对照组分别使用拉坦前列素的载体（第 3 组）或生理缓冲盐水溶液（第 4 组）。在基线、第 1 个月和第 6 个月治疗时均进行 LSCM 和 IC，主要观察指标为 GC 密度（GCD）（细胞/mm²）。

结果

基线。第 1 组和第 2 组的 LSCM 检测 GC 密度的平均值分别为 240.69±25.43 和 232.65±23.52，IC 检测的平均值分别为 162.10±23.44 和 164.71±21.03。第 3 组和第 4 组的 GC 密度值无显著差异（p＞0.05）。第 1 个月。第 1 组的 LSCM 和 IC 检测的 GCD 平均值分别增加至 284.16±43.88 和 230.62±48.32（p＜0.001），第 2 组分别增加至 297.86±26.87 和 221.78±43.02（p＜0.05）。第 3 组的 LSCM 和 IC 检测的 GCD 平均值分别下降至 205.88±25.04 和 139.54±17.37（p＜0.05）。第 6 个月。第 1 组的 GCD 无显著变化（p＞0.05），而第 2 组的 GCD 与第 1 个月相比下降（p＜0.05）。第 3 组的 LSCM 和 IC 检测的 GCD 平均值分别进一步下降至 166.32±22.31 和 120.76±11.66（p＜0.05）；第 4 组在研究期间 GCD 无显著变化（p＞0.05）。