Radenković Marija, Stanković-Babić Gordana, Jovanović Predrag, Djordjević-Jocić Jasmina, Trenkić-Božinović Marija
Srp Arh Celok Lek. 2016 Jul-Aug;144(7-8):376-83.
Ocular surface disease (OSD) is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbances, tear film instability with potential damage to the ocular surface, accompanied by increased tear film osmolarity and inflammation of the ocular surface. It is a consequence of disrupted homeostasis of lacrimal functional unit. The main pathogenetic mechanism stems from tear hyperosmolarity and tear film instability. The etiological classification is hyposecretory (Sy-Sjögren and non-Sjögren) and evaporative (extrinsic and intrinsic) form. Delphi panel classification grades disease stages. Antiglaucoma topical therapy causes exacerbation or occurrence of symptoms of dry eye due to main ingredients or preservatives (benzalkonium chloride – BAK), which are dose- and time-dependent. BAK reduces the stability of the lipid layer of tears, the number of goblet cells, induces apoptosis and inflammatory infiltration.
The aim of this study was the analysis of the OSD incidence in open-angle glaucoma patients caused by topical medicamentous therapy.
Retrospective analysis of examined patients with open-angle glaucoma was used.
Increased incidence of moderate and advanced OSD Index degrees in the group of primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma. According to the Delphi Panel Scale the most common grade is IIb (POAG and pseudoexfoliative glaucoma). Evaporative form of OSD prevailed in all treatment groups. High percentage of dry eye in patients with higher concentrations of preservatives applied was noticed.
OSD should be timely diagnosed and treated. Dry eye has an impact on surgical outcome and postoperative visual acuity, and in order to improve patient compliance and quality of life, symptoms of dry eye should be addressed and medications with lower concentrations of preservatives should be applied.
眼表疾病（OSD）是一种累及泪液和眼表的多因素疾病，可导致不适症状、视觉障碍、泪膜不稳定，并可能对眼表造成损害，同时伴有泪膜渗透压升高和眼表炎症。它是泪液功能单位稳态破坏的结果。主要发病机制源于泪液高渗和泪膜不稳定。病因分类包括分泌减少型（干燥综合征和非干燥综合征）和蒸发过强型（外源性和内源性）。德尔菲专家组分类对疾病阶段进行分级。抗青光眼局部治疗因主要成分或防腐剂（苯扎氯铵 - BAK）可导致干眼症状加重或出现，且具有剂量和时间依赖性。BAK会降低泪液脂质层的稳定性、杯状细胞数量，诱导细胞凋亡和炎症浸润。
本研究旨在分析局部药物治疗引起的开角型青光眼患者中眼表疾病的发生率。
采用回顾性分析方法对接受检查的开角型青光眼患者进行研究。
原发性开角型青光眼（POAG）和剥脱性青光眼组中，中重度眼表疾病指数等级的发生率增加。根据德尔菲专家组量表，最常见的等级为IIb（POAG和剥脱性青光眼）。蒸发过强型眼表疾病在所有治疗组中占主导。注意到使用较高浓度防腐剂的患者干眼比例较高。
眼表疾病应及时诊断和治疗。干眼会影响手术效果和术后视力，为提高患者依从性和生活质量，应处理干眼症状并应用防腐剂浓度较低的药物。
