Abstract
Corneal thickness measurement is important for assessing intraocular pressure in patients with glaucoma. This study investigated the changes in corneal epithelial thickness (CET) induced by antiglaucoma medications and explored the factors affecting CET measurement. CET was measured over a 9.0 mm diameter area by using Fourier domain optical coherence tomography in 125 patients with primary open-angle glaucoma and 125 age-matched controls without glaucoma. The influence of sex, age, benzalkonium chloride (BAK)-containing instillations, disease severity, and types and numbers of medications was analyzed using simple and multiple regression analyses. CET over 25 sectors was smaller in the glaucoma group than in the control group (mean difference of 4.2 µm in the central 2.0 mm zone; 52.8 ± 3.6 vs. 48.5 ± 3.9, p < 0.001). Simple regression analysis revealed age, use of β-blockers, prostaglandin, carbonic anhydrase inhibitors, total number of medications, and number of daily BAK-containing instillations were associated with a thinner epithelium. Multiple regression analysis revealed β-blockers, prostaglandin, and number of BAK-containing instillations were significant factors. Use of β-blockers and number of BAK-containing instillations were also associated with a thinner epithelium in the monotherapy subgroup analysis. CET was significantly smaller in patients with glaucoma receiving topical medications and was affected by the use of β-blockers, prostaglandin, and BAK.
Highlights
In our 250-individual cohort comparison, corneal epithelial thickness (CET) in all 25 sectors over the 9.0 mm diameter area was smaller in the glaucoma group than in the control group (Figure 1)
Simple regression analysis indicated that age, visual field index, use of β-blockers, prostaglandin, carbonic anhydrase inhibitors (CAIs), α-agonists, total number of medications, and number of daily benzalkonium chloride (BAK)-containing instillations were associated with a thinner epithelium
Given the fact that most patients with glaucoma were treated using more than one medication, our finding suggests the augmented effects or dose-dependent effects of BAK on the corneal epithelium
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Measurement of corneal thickness has played an important diagnostic role in the assessment of intraocular pressure (IOP) in patients with glaucoma [1,2,3]. Central corneal thickness (CCT) is an independent risk factor for glaucoma, and potential factors affecting corneal thickness measurements or their association with IOP measurements have been extensively studied [3,4]. The recent development of topographic mapping using
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