Cui Xinhan, Xiang Jun, Zhu Wenqing, Wei Anji, Le Qihua, Xu Jianjiang, Zhou Xiaodong
*Ophthalmology Department, Eye and ENT Hospital of Fudan University †Ophthalmology Department, Jinshan Hospital of Fudan University, Shanghai, China.
J Glaucoma. 2016 Jun;25(6):487-92. doi: 10.1097/IJG.0000000000000316.
To investigate the protective effects of vitamin A palmitate and carbomer gel on the morphology of conjunctival epithelium and density of goblet cells (GCs) in patients on long-term prostaglandin analogs (PGAs) application.
In this prospective cohort study, 23 primary open-angle glaucoma patients and 7 normal-tension glaucoma patients prescribed PGAs for >1 year were enrolled into 3 identical clinical trials and randomized into 3 groups (10 per group). Patients were treated twice daily with vitamin A palmitate eye gel 0.1%, or carbomer eye gel 0.2%, or no additional application of these 2 drugs. Ocular surface disease index questionnaires, Schirmer 1 test without anesthesia, tear break-up time test, and GCs density assessment by in vivo confocal microscopy and conjunctival impression cytology analysis were performed at baseline and at months 1, 3, and 6 of the study.
Both vitamin A palmitate and carbomer gel led to a significant improvement in ocular surface disease index questionnaires score and prevented the gradual decline in tear break-up time. Vitamin A palmitate significantly increased the GC density after treatment. The GC density assessed by in vivo confocal microscopy positively correlated with that measured by conjunctival impression cytology.
Vitamin A palmitate and carbomer eye gel can effectively relieve dry eye symptom caused by long-term application of PGAs by increasing the GCs density and thereby reducing the toxicity to the conjunctiva. Vitamin A palmitate and carbomer eye gel may be valuable alternatives for glaucoma patients who prescribed long-term PGAs.
探讨棕榈酸视黄酯和卡波姆凝胶对长期应用前列腺素类似物（PGA）患者结膜上皮形态和杯状细胞（GCs）密度的保护作用。
在这项前瞻性队列研究中，将23例原发性开角型青光眼患者和7例眼压正常的青光眼患者纳入3项相同的临床试验，这些患者均已使用PGA超过1年，并随机分为3组（每组10例）。患者每天两次分别使用0.1%的棕榈酸视黄酯眼凝胶、0.2%的卡波姆眼凝胶，或不额外使用这两种药物。在研究基线以及第1、3和6个月时，进行眼表疾病指数问卷调查、无麻醉下的Schirmer 1试验、泪膜破裂时间试验，以及通过活体共聚焦显微镜和结膜印迹细胞学分析评估GCs密度。
棕榈酸视黄酯和卡波姆凝胶均使眼表疾病指数问卷评分显著改善，并防止泪膜破裂时间逐渐下降。治疗后，棕榈酸视黄酯显著提高了GCs密度。通过活体共聚焦显微镜评估的GCs密度与通过结膜印迹细胞学测量的结果呈正相关。
棕榈酸视黄酯和卡波姆眼凝胶可通过增加GCs密度，从而降低对结膜的毒性，有效缓解长期应用PGA引起的干眼症状。对于长期使用PGA的青光眼患者，棕榈酸视黄酯和卡波姆眼凝胶可能是有价值的替代药物。
