Effects of Long-Term Antiglaucoma Eye Drops on Conjunctival Structures: An In Vivo Confocal Microscopy Study.

Wenqing Zhu,Xinghuai Sun,Jianjiang Xu,Xiangmei Kong

doi:10.1155/2015/165475

Wenqing Zhu, Xinghuai Sun + Show 2 more

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https://doi.org/10.1155/2015/165475

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Abstract

Purpose. The study was aimed at comparing the long-term effects of different antiglaucoma eye drops on conjunctival structures using laser scanning confocal microscopy. Methods. Eighty patients diagnosed with primary open-angle glaucoma and twenty healthy volunteers were included in this study. The participants were divided into 5 groups according to the different medications. The lachrymal film break-up time, Schirmer's I test, and Ocular Surface Disease Index Questionnaire were performed in all subjects. The confocal microscopy was used to observe the basal epithelial cell density (ECD), goblet cell density (GCD), dendritic cell density (DCD), and subepithelial collagen fiber diameter (SFD). Results. Statistically significant differences were found among the control group and the antiglaucoma therapy groups in the values of three clinical data (P < 0.05). The GCD, DCD, and SFD showed significant differences in all glaucoma groups when compared to the control (P < 0.001). Moreover, the prostaglandin group differed from the other antiglaucoma therapy groups in the GCD and SFD (P < 0.05). Conclusions. Our study confirmed the significant differences in the conjunctival structures based on the effects of antiglaucoma medications. Less pronounced changes were found in the patients treated with prostaglandin analogue than in the other kinds of antiglaucoma therapies.

Highlights

Glaucoma is a chronic, progressive, optic neuropathy requiring the long-term use of antiglaucoma eye drops
This study aimed to evaluate conjunctival structures, including the epithelial cell density (ECD), goblet cell density (GCD), dendritic cell density (DCD), and subepithelial collagen fiber diameter (SFD), using laser scanning confocal microscopy (LSCM), and to assess the tear function using Schirmer’s I test (ST) and the lachrymal film break-up time (BUT) in subjects exhibiting the long-term use of topical antiglaucoma therapy
The prostaglandin group revealed a statistically significant difference when compared with the other glaucoma groups, whereas there was no pronounced difference between the other antiglaucoma therapy groups

Summary

Introduction

Progressive, optic neuropathy requiring the long-term use of antiglaucoma eye drops. These medications containing preservatives may induce ocular damage, such as squamous metaplasia, subconjunctival fibrosis, and a decrease in goblet cells [1]. It is of utmost importance to compare the effects of various antiglaucoma therapies with preservatives, which likely stimulate inflammation, on the ocular surface. A marker of inflammation, was confirmed to be slightly higher in the patients treated with preservative-free timolol than in the control [5]. Preserved latanoprost causes an increase in human leucocyte antigen expression, when compared with preservatives alone [6]

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