Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India
Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India.
Br J Ophthalmol. 2021 Jan;105(1):141-148. doi: 10.1136/bjophthalmol-2019-314234. Epub 2019 Aug 5.
To evaluate tear neuropeptides (NPs) (vasoactive intestinal peptide (VIP), neuropeptide Y (NPY), calcitonin gene-related peptide (CGRP), substance P (SP), nerve growth factor (NGF)) in chronic ocular topical hypotensive therapy with and without benzalkonium chloride (BAK) preservative.
A comparative, open label, cross-sectional study of patients using antiglaucoma medications for 6 months with BAK (group I), without BAK (group II) and controls was done. Tear NPs (ELISA), ocular surface evaluation tests (tear breakup time (TBUT), Schirmer's test, corneal and conjunctival staining score) and confocal central corneal subbasal nerve fibre layer (SBNFL) imaging was done.
Of 153 eyes evaluated, group 1 (82 eyes (41 patients; mean age 48±14.5 years)) and group 2 (71 eyes (36 patients; mean age 43.11±15 years)) were on therapy for a mean duration of 10.05±2.0 and 9.67±2.3 months, respectively. Tear analysis showed elevated SP and NGF (p<0.01); decreased CGRP (p=0.03), VIP and NPY (p<0.01) compared with controls (n=30, mean age 29.33±5.7 years). Tear NP levels (SP (p=0.1), NGF (p=0.33), CGRP (p=1), VIP (p=0.87), NPY (p=0.83)) and SBNFL (p=0.09) were comparable in both groups. There was no correlation seen between tear NP levels and clinical tests and SBNFL.
Our study analysis points towards altered tear NP levels in eyes on chronic topical hypotensive therapy in comparison with controls with no significant difference in tear NP levels and central corneal SBNFL density between the BAK preservative and BAK-free antiglaucoma therapy.
评估慢性眼部局部降眼压治疗中（有/无苯扎氯铵（BAK）防腐剂）泪液神经肽（NPs）（血管活性肠肽（VIP）、神经肽 Y（NPY）、降钙素基因相关肽（CGRP）、P 物质（SP）、神经生长因子（NGF））。
对使用青光眼药物治疗 6 个月的患者进行了一项比较、开放标签、横断面研究，这些患者使用了含 BAK（I 组）、不含 BAK（II 组）和对照组的药物。进行了泪液 NP（ELISA）、眼表面评估试验（泪膜破裂时间（TBUT）、Schirmer 试验、角膜和结膜染色评分）和共聚焦中央角膜基质神经纤维层（SBNFL）成像。
在评估的 153 只眼中，第 1 组（82 只眼（41 例患者；平均年龄 48±14.5 岁））和第 2 组（71 只眼（36 例患者；平均年龄 43.11±15 岁））的治疗平均持续时间分别为 10.05±2.0 和 9.67±2.3 个月。泪液分析显示，与对照组（n=30，平均年龄 29.33±5.7 岁）相比，SP 和 NGF 升高（p<0.01）；CGRP（p=0.03）、VIP 和 NPY 降低（p<0.01）。泪液 NP 水平（SP（p=0.1）、NGF（p=0.33）、CGRP（p=1）、VIP（p=0.87）、NPY（p=0.83））和 SBNFL（p=0.09）在两组之间无差异。泪液 NP 水平与临床检查和 SBNFL 之间无相关性。
与对照组相比，慢性局部降眼压治疗的患者的泪液 NP 水平发生了改变，但 BAK 防腐剂和无 BAK 青光眼治疗之间的泪液 NP 水平和中央角膜 SBNFL 密度没有显著差异。
