Aribaba Olufisayo Temitayo, Adenekan Olusesan Adetunji, Alabi Adegboyega Sunday, Aina Mobolaji Taiwo, Anunobi Charles Chidozie, Onakoya Adeola Olukorede
Department of Ophthalmology, College of Medicine, University of Lagos; Guinness Eye Centre, Lagos University Teaching Hospital, Lagos, Nigeria.
Department of Anatomic and Molecular Pathology, College of Medicine, University of Lagos, Lagos, Nigeria.
Niger Postgrad Med J. 2023 Jul-Sep;30(3):240-249. doi: 10.4103/npmj.npmj_99_23.
The long-term use of topical anti-glaucoma medications is often associated with ocular surface toxicity that can affect the patient's drug compliance and quality of life. This study assessed the effect of these medications, using cytological changes of the conjunctiva and ocular surface symptoms.
This was a clinic-based, case-control study that was conducted at the Lagos University Teaching Hospital that compared glaucoma patients on topical medications with age-sex-matched controls. The controls were non-glaucoma patients, who were not on any topical ocular medications at least 6 months prior to the study. The Ocular Surface Disease Index (OSDI) questionnaire was used to assess ocular surface symptoms. Schirmer's I test, tear film break-up time (TBUT) test and corneal fluorescein staining of the ocular surface were used for ocular surface disease (OSD) assessment and conjunctival impression cytology (CIC) for histological assessment and grading.
Six hundred and ninety-six eyes of 348 respondents, 174 cases and 174 controls, were assessed for OSD. The mean ages of the case and control groups were 56.3 ± 12.9 years and 55.5 ± 13.2 years, respectively, with no statistical difference (P = 0.589). All ocular parameters assessed were significantly abnormal in the case group compared to the control group. The use of topical anti-glaucoma medications was significantly associated with abnormal TBUT (P < 0.001), Schirmer's test (P < 0.001), ocular surface staining (P < 0.001), CIC (P < 0.001) and OSDI scores (P = 0.001). A significant association was seen between abnormal TBUT and the number of medications (P = 0.044, odds ratio [OR] =0.79, 95% confidence interval [CI]: 0.44-1.14), between abnormal ocular surface staining and duration of anti-glaucoma medications usage (P = 0.0104, OR = 1.2, 95% CI: 1.04-1.43) and between abnormal CIC and the duration of anti-glaucoma medications (P = 0.0007, OR = 0.7, 95% CI: 0.59-0.86).
The study demonstrates that prolonged use of topical anti-glaucoma medications may be associated with damage to the ocular surface structures.
长期使用局部抗青光眼药物常与眼表毒性相关，这可能影响患者的药物依从性和生活质量。本研究利用结膜的细胞学变化和眼表症状评估了这些药物的效果。
这是一项在拉各斯大学教学医院进行的基于临床的病例对照研究，将使用局部药物的青光眼患者与年龄和性别匹配的对照组进行比较。对照组为非青光眼患者，在研究前至少6个月未使用任何局部眼用药物。使用眼表疾病指数（OSDI）问卷评估眼表症状。采用Schirmer I试验、泪膜破裂时间（TBUT）试验和眼表角膜荧光素染色评估眼表疾病（OSD），并采用结膜印迹细胞学（CIC）进行组织学评估和分级。
对348名受访者的696只眼睛进行了OSD评估，其中174例为病例组，174例为对照组。病例组和对照组的平均年龄分别为56.3±12.9岁和55.5±13.2岁，无统计学差异（P = 0.589）。与对照组相比，病例组所有评估的眼部参数均明显异常。局部抗青光眼药物的使用与TBUT异常（P < 0.001）、Schirmer试验异常（P < 0.001）、眼表染色异常（P < 0.001）、CIC异常（P < 0.001）和OSDI评分异常（P = 0.001）显著相关。TBUT异常与药物数量之间存在显著关联（P = 0.044，比值比[OR]=0.79，95%置信区间[CI]：0.44 - 1.14），眼表染色异常与抗青光眼药物使用时间之间存在显著关联（P = 0.0104，OR = 1.2，95% CI：1.04 - 1.43），CIC异常与抗青光眼药物使用时间之间存在显著关联（P = 0.0007，OR = 0.7，95% CI：0.59 - 0.86）。
该研究表明，长期使用局部抗青光眼药物可能与眼表结构损伤有关。
