Pérez Bartolomé Francisco, Martínez de la Casa Jose María, Arriola Villalobos Pedro, Fernández Pérez Cristina, Polo Vicente, Sánchez Jean Ruben, García Feijoó Julián
a Ophthalmology, Hospital Clínico San Carlos , Instituto de Investigación Sanitaria San Carlos (IdISSC) , Madrid , Spain.
b Ramon Castroviejo Institute , Universidad Complutense , Madrid , Spain.
Semin Ophthalmol. 2018;33(5):643-650. doi: 10.1080/08820538.2017.1395891. Epub 2017 Nov 16.
To examine correlations between ocular redness measured with the new topographer Keratograph 5M and the use of topical anti-glaucoma medication.
A total of 211 eyes of 211 patients with open-angle glaucoma or ocular hypertension on topical medication and 51 eyes of 51 healthy volunteers were recruited over 10 months. Outcome variables were keratograph redness scores (RS): overall, bulbar temporal (BT), bulbar nasal (BN), limbar temporal (LT), and limbar nasal (LN). In each subject, we also recorded the intraocular pressure-lowering eye drops used, daily doses and daily and cumulative preservative concentrations, fluorescein corneal staining score (OXFORD), lower tear meniscus height (Fourier-domain OCT), non-invasive tear film breakup time (Keratograph 5M), and ocular surface disease questionnaire index (OSDI).
Higher RS were recorded in the medication than control group (P < 0.01 all scores). Within the medication group, older patients returned greater RS (P < 0.05 all scores). Prostaglandin was a strong predictor of higher scores, except LN RS. A higher OSDI was associated with a higher LN RS (β = 0.007; P < 0.05), while the use of β-blockers was linked to a lower LN RS (β = -0.225; P < 0.05). The use of ≥3 daily eye drops with preservative gave rise to a higher BN RS and ≥3 daily eye drops to a higher LN RS (β = 0.366, P < 0.01; β = 0.296, P < 0.05, respectively).
Keratograph 5M can objectively detect the hyperaemia induced by glaucoma medication. The factors contributing to ocular redness were advanced age, more daily eye drops (nasal sectors), a higher OSDI, and prostaglandin as the medication used.
探讨使用新型角膜地形图仪Keratograph 5M测量的眼部发红与局部抗青光眼药物使用之间的相关性。
在10个月内招募了211例使用局部药物治疗的开角型青光眼或高眼压症患者的211只眼以及51名健康志愿者的51只眼。观察指标为角膜地形图仪发红评分(RS):总体、球结膜颞侧(BT)、球结膜鼻侧(BN)、角膜缘颞侧(LT)和角膜缘鼻侧(LN)。在每个受试者中,我们还记录了所使用的降眼压滴眼液、每日剂量以及每日和累积防腐剂浓度、荧光素角膜染色评分(牛津分级)、泪液半月板高度降低(傅里叶域光学相干断层扫描)、非侵入性泪膜破裂时间(Keratograph 5M)和眼表疾病问卷指数(OSDI)。
用药组的RS高于对照组(所有评分P < 0.01)。在用药组中,年龄较大的患者RS更高(所有评分P < 0.05)。除LN RS外,前列腺素是评分升高的强预测因素。较高的OSDI与较高的LN RS相关(β = 0.007;P < 0.05),而使用β受体阻滞剂与较低的LN RS相关(β = -0.225;P < 0.05)。每天使用≥3种含防腐剂的滴眼液会导致较高的BN RS,每天使用≥3种滴眼液会导致较高的LN RS(分别为β = 0.366,P < 0.01;β = 0.296,P < 0.05)。
Keratograph 5M可以客观地检测青光眼药物引起的充血。导致眼部发红的因素包括年龄较大、每日滴眼液使用量较多(鼻侧象限)、较高的OSDI以及使用前列腺素类药物。