埃塞俄比亚一家三级医院中，使用局部降压药物的青光眼患者的干眼疾病。
Dry eye disease among Glaucoma patients on topical hypotensive medications, in a tertiary hospital, Ethiopia.
机构信息
Department of Ophthalmology, Menelik II Hospital, School of Medicine, College of Health Sciences, Addis Ababa University, P.O.Box 8079, Addis Ababa, Ethiopia.
出版信息
BMC Ophthalmol. 2021 Mar 30;21(1):155. doi: 10.1186/s12886-021-01917-3.
BACKGROUND
Dry eye disease is a multifactorial disease; causing various ocular symptoms with potential damage to the ocular surface. Applying hypotensive eye drops are presumed to initiate or exacerbate existing dry eye disease. The purpose of this study was to determine the frequency of signs and symptoms and severity of dry eye disease among glaucoma patients on topical hypotensive medications and controls.
METHODS
A cross-sectional comparative study, involving 320 glaucoma patients and controls. Ocular Surface Disease Index (OSDI) symptoms score and Schirmer, tear breakup time and corneal staining tests were used to assess dry eye disease. Data was analyzed using SPSS version 24 software; p-value less than 0.05 was considered as statistically significant.
RESULTS
Among the 160 study glaucoma patients, the mean duration of topical hypotensive medication use was 5.2 ± 5.21 years (range, 4 months - 32 years). Mild to severe level of OSDI score was found in 122 (76%) glaucoma patients and in 137 (86%) controls (p = 0.033). Mild to sever abnormal clinical tests in the glaucoma patients and control, respectively, were 106 (66%) vs 80 (50%) corneal staining (p = 0.045), 79 (49%) vs 72 (45%) TBUT (p = 0.021), and 91 (57%) vs 83 (52%) Schirmer test (p = 0.242). Test results at the level of sever: 2 (1%) vs 0 (0%) corneal staining, 50 (31%) vs 39 (24%) TBUT and 65 (41%) vs 60 (38%) Schirmer test in the glaucoma patents and controls, respectively. Corneal staining and TBUT had correlation with the number of drugs (p = 0.004 and 0.031, respectively), and more relationship of the two tests with total number of drops applied per day (p = 0.01 and p < 0.001, respectively). Patients on pilocarpine and timolol had more corneal staining and lower TBUT [(p = 0.011 and p < 0.001) and (p = 0.04 and 0.012), respectively].
CONCLUSIONS
The study has identified glaucoma patients to be more affected by dry eye disease than non-glaucoma patients, and presence of significantly lower TBUT and higher corneal staining in the glaucoma patients on multidrops and multidose per day. We recommend consideration of evaluation and management of DED for glaucoma patients on multidrops and multidose hypotensive medications.
背景
干眼是一种多因素疾病，可导致各种眼部症状，并可能对眼表造成潜在损害。使用降眼压眼药水可能会引发或加重现有的干眼。本研究的目的是确定青光眼患者在使用局部降眼压药物和对照组中干眼的体征和症状的频率和严重程度。
方法
这是一项横断面比较研究，共纳入 320 名青光眼患者和对照组。使用眼表面疾病指数（OSDI）症状评分和泪液分泌试验、泪膜破裂时间和角膜染色试验来评估干眼。数据使用 SPSS 版本 24 软件进行分析；p 值小于 0.05 被认为具有统计学意义。
结果
在 160 名研究的青光眼患者中，局部降眼压药物使用的平均时间为 5.2±5.21 年（范围 4 个月至 32 年）。122 名（76%）青光眼患者和 137 名（86%）对照组患者的 OSDI 评分存在轻至重度（p=0.033）。青光眼患者和对照组的轻度至重度异常临床检查分别为 106 名（66%）与 80 名（50%）的角膜染色（p=0.045）、79 名（49%）与 72 名（45%）的泪膜破裂时间（p=0.021）和 91 名（57%）与 83 名（52%）的 Schirmer 试验（p=0.242）。在青光眼患者和对照组中，严重程度为 2 名（1%）与 0 名（0%）的角膜染色、50 名（31%）与 39 名（24%）的泪膜破裂时间和 65 名（41%）与 60 名（38%）的 Schirmer 试验。角膜染色和泪膜破裂时间与药物种类（p=0.004 和 0.031）有关，与每天滴药次数（p=0.01 和 p<0.001）的关系更密切。使用毛果芸香碱和噻吗洛尔的患者角膜染色更多，泪膜破裂时间更短（p=0.011 和 p<0.001）和（p=0.04 和 p=0.012）。
结论
本研究表明，与非青光眼患者相比，青光眼患者更容易受到干眼的影响，并且在使用多种药物和每日多次滴眼的青光眼患者中，泪膜破裂时间明显较低，角膜染色较高。我们建议对使用多种药物和每日多次滴眼的青光眼患者评估和管理干眼。
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