Department of Medicine and Aging Science, Ophthalmology Clinic, G. D'Annunzio University of Chieti-Pescara, Chieti.
IRCCS Fondazione G.B. Bietti.
J Glaucoma. 2020 May;29(5):374-380. doi: 10.1097/IJG.0000000000001469.
The purpose of this study was to investigate the tear meniscus in medically controlled glaucoma patients (MCGP) using anterior segment-optical coherence tomography (AS-OCT).
Fifty-six MCGP, 24 patients with evaporative dry eye (EDE), and 30 healthy subjects (controls), were enrolled. MCGP were divided into group 1 (14 eyes): β-blockers; group 2 (14 eyes): prostaglandin analogs; group 3 (28 eyes) ≥2 drugs. Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time, corneal fluorescein staining, Schirmer Test I, and tear meniscus height (lower and upper: L-TMH, U-TMH) and area (L-TMA, U-TMA) using AS-OCT, were performed.
OSDI score was higher (P<0.05) in patients with EDE and in group 3 compared with groups 1, 2, and controls. No significant differences were found between group 3 and patients with EDE for all clinical parameters. L-TMA was significantly lower in groups 1 to 3 (P<0.05) and in EDE patients (P<0.001) compared with controls, and it was lower in group 3 and in EDE patients compared with groups 1 and 2 (P<0.05). L-TMH was lower in groups 1 to 3 and in EDE patients compared with controls (P<0.001), and in EDE patients and in group 3 compared with groups 1 and 2 (P<0.05). U-TMA was lower in EDE and MCGP groups compared with controls (P<0.05). L-TMA and L-TMH negatively correlated with OSDI score (P<0.01, r=-0.379 and P<0.01, r=-0.352, respectively).
AS-OCT permits a noninvasive and reliable tear meniscus imaging in medically controlled glaucoma, depicting the glaucoma-related ocular surface disease as a dry eye disease-like condition. Thus, reduced values of TMH and TMA can be proposed as structural indicators of glaucoma therapy-related ocular surface disease.
本研究旨在使用眼前节光学相干断层扫描（AS-OCT）研究经医学控制的青光眼患者（MCGP）的泪膜半月板。
纳入 56 例 MCGP、24 例蒸发性干眼症（EDE）患者和 30 名健康受试者（对照组）。MCGP 分为 1 组（14 只眼）：β受体阻滞剂；2 组（14 只眼）：前列腺素类似物；3 组（28 只眼）：≥2 种药物。使用 AS-OCT 进行眼表疾病指数（OSDI）问卷、泪膜破裂时间、角膜荧光素染色、Schirmer I 试验和泪膜半月板高度（下和上：L-TMH、U-TMH）和面积（L-TMA、U-TMA）。
EDE 患者和 3 组患者的 OSDI 评分均较高（P<0.05），与 1 组、2 组和对照组相比。3 组患者与 EDE 患者的所有临床参数均无显著差异。与对照组相比，1 至 3 组（P<0.05）和 EDE 患者（P<0.001）的 L-TMA 明显降低，与 1 组和 2 组相比，3 组和 EDE 患者的 L-TMA 也降低（P<0.05）。与对照组相比，1 至 3 组和 EDE 患者的 L-TMH 较低（P<0.001），与 1 组和 2 组相比，EDE 患者和 3 组的 L-TMH 也较低（P<0.05）。与对照组相比，EDE 组和 MCGP 组的 U-TMA 较低（P<0.05）。L-TMA 和 L-TMH 与 OSDI 评分呈负相关（P<0.01，r=-0.379 和 P<0.01，r=-0.352）。
AS-OCT 可对视神经控制的青光眼进行非侵入性和可靠的泪膜半月板成像，将青光眼相关的眼表疾病描绘为干眼症样疾病。因此，TMH 和 TMA 值的降低可作为青光眼治疗相关眼表疾病的结构指标。
