Kamath A P, Satyanarayana S, Rodrigues Fea
Senior Advisor (Ophthalmology), Command Hospital (EC), Kolkata -700027.
Ex-Classified Specialist (Ophthalmology) Command Hospital (NC), C/o 56 APO.
Med J Armed Forces India. 2007 Oct;63(4):341-5. doi: 10.1016/S0377-1237(07)80011-6. Epub 2011 Jul 21.
Topical life long anti glaucoma medication forms the mainstay of treatment of primary open angle glaucoma. Their long term usage can cause changes in conjunctival epithelium.
Hundred cases of primary open angle glaucoma were divided into four groups of 25 patients each. Each group was put on Timolol, Pilocarpine, Brimonidine and Latanoprost respectively. Ocular surface changes were monitored using Schirmer's test, tear film break up time (BUT) and conjunctival impression cytology.
Altered Schirmer's test value was seen in 40% of patients and reduced tear film BUT values in 26%, at the end of one year. These changes were more in patients treated with timolol. Changes in conjunctival cytology such as decrease in goblet cell density, squamous metaplasia and presence of inflammatory cells were seen in significant number of patients at the end of one year treatment. There was direct relation of duration of treatment to various ocular surface changes.
Ocular surface changes are seen in significant number of patients of primary open angle glaucoma at the end of one year follow up with topical anti glaucoma therapy. Conjunctival impression cytology is a non invasive technique to monitor these changes.
局部长期使用抗青光眼药物是原发性开角型青光眼治疗的主要手段。其长期使用可导致结膜上皮发生变化。
将100例原发性开角型青光眼患者分为四组，每组25例。每组分别使用噻吗洛尔、毛果芸香碱、溴莫尼定和拉坦前列素。使用泪液分泌试验、泪膜破裂时间（BUT）和结膜印迹细胞学检查来监测眼表变化。
一年后，40%的患者泪液分泌试验值发生改变，26%的患者泪膜破裂时间缩短。噻吗洛尔治疗的患者这些变化更为明显。一年治疗结束时，大量患者出现结膜细胞学改变，如杯状细胞密度降低、鳞状化生和炎性细胞出现。治疗持续时间与各种眼表变化存在直接关系。
在局部抗青光眼治疗一年随访结束时，大量原发性开角型青光眼患者出现眼表变化。结膜印迹细胞学检查是监测这些变化的一种非侵入性技术。
