Lee Sang Yeop, Lee Hun, Bae Hyoung Won, Kim Tae-Im, Kim Chan Yun
*MD†MD, PhDDepartment of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul (SYL, HWB, TIK, CYK); Kong Eye Center, Seoul (SYL); and Department of Ophthalmology, International St. Mary's Hospital, Catholic Kwandong University, Inchon, Korea (HL).
Optom Vis Sci. 2016 Oct;93(10):1210-1217. doi: 10.1097/OPX.0000000000000943.
To investigate the effects of topical anti-glaucoma medications on tear lipid layer thickness (LLT) and the ocular surface.
This retrospective study examined ocular surface disease (OSD) subjects who had (n = 34) and who did not have (n = 51) open-angle glaucoma (OAG). OSD was evaluated with lipid layer thickness (using LipiView interferometer), tear breakup time (TBUT), total corneal and conjunctival staining (Oxford grading scale), and Ocular Surface Disease Index (OSDI). Four variables (total duration of anti-glaucoma medication use, duration of current anti-glaucoma medication use, total number of daily anti-glaucoma medication drops applied, and total number of anti-glaucoma medications [bottles]) related to anti-glaucoma medication were used to verify associations with LLT.
Among the parameters, only LLT showed significantly lower values in the OAG group. In both groups, total staining showed a significant negative correlation between LLT and TBUT. Only in the OAG group, the OSDI showed significant correlations with number of medications (r = 0.389, p = 0.012) and daily number of drops (r = 0.354, p = 0.02); LLT showed significant correlations with TBUT (r = 0.381, p = 0.026) and total medication duration (r = -0.387, p = 0.013). In multivariate analyses, TBUT and total medication duration showed significant correlations with LLT (p = 0.032 and p = 0.015, respectively) in the OAG group.
Topically medicated OAG subjects with OSD had a lower tear LLT than those with OSD who did not have OAG. Therefore, our results indicate that one should evaluate ocular surface disease status in patients who take anti-glaucoma medications.
研究局部抗青光眼药物对泪液脂质层厚度（LLT）及眼表的影响。
本回顾性研究检查了患有开角型青光眼（OAG）（n = 34）和未患有开角型青光眼（n = 51）的眼表疾病（OSD）受试者。通过脂质层厚度（使用LipiView干涉仪）、泪膜破裂时间（TBUT）、角膜和结膜总染色（牛津分级量表）以及眼表疾病指数（OSDI）评估眼表疾病。使用与抗青光眼药物相关的四个变量（抗青光眼药物使用的总时长、当前抗青光眼药物的使用时长、每日抗青光眼药物滴眼的总数以及抗青光眼药物的总数[瓶数]）来验证与LLT的关联。
在各项参数中，仅LLT在OAG组中显示出显著较低的值。在两组中，总染色显示LLT与TBUT之间存在显著负相关。仅在OAG组中，OSDI与药物数量（r = 0.389，p = 0.012）和每日滴眼数（r = 0.354，p = 0.02）显示出显著相关性；LLT与TBUT（r = 0.381，p = 0.026）和总用药时长（r = -0.387，p = 0.013）显示出显著相关性。在多变量分析中，OAG组中TBUT和总用药时长与LLT显示出显著相关性（分别为p = 0.032和p = 0.015）。
患有OSD的局部用药OAG受试者的泪液LLT低于未患有OAG的OSD受试者。因此，我们的结果表明，应评估服用抗青光眼药物患者的眼表疾病状况。
