Abstract
BackgroundLong-term use of topical, especially benzalkonium chloride (BAC)-preserved, antiglaucoma medications can cause a negative impact on the ocular surface. The aim of the study was to assess the effect of topical carbonic anhydrase inhibitors (CAIs) on selected oxidative stress biomarkers in the tear film.MethodsThe patients were divided into four sex-matched groups: group C (n = 25) – control group – subjects who did not use topical antiglaucoma medications, group DL (n = 14) – patients using preservative-free dorzolamide, group DL + BAC (n = 16) – patients using topical BAC-preserved dorzolamide, group BL + BAC (n = 17) – patients using BAC-preserved brinzolamide. Subjects in all the study groups have been using the eye drops two times daily for 6–12 months. The oxidative stress biomarkers in the tear film samples were measured: total protein (TP) concentration, advanced oxidation protein products (AOPP) content, total sulfhydryl (-SH) groups content, the activity of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx), as well as Total Oxidant Status (TOS), Total Antioxidant Response (TAR), and Oxidative Stress Index (OSI).ResultsThe advanced oxidation protein products content, Total Oxidant Status as well as superoxide dismutase and catalase activities in the group DL + BAC and BL + BAC were higher in comparison with the group C. The total sulfhydryl groups content was lower in the group DL + BAC and BL + BAC when compared to group C. Oxidative Stress Index was higher in the groups DL + BAC and BL + BAC in comparison with the groups DL and C.ConclusionsUse of topical benzalkonium chloride-preserved carbonic anhydrase inhibitors increases oxidative stress in the tear film.
Highlights
Glaucoma is a group of eye diseases representing a wide spectrum of clinical presentations and etiologies, which can lead to a permanent loss of visual function due to progressive degeneration of the retinal ganglion cells and nerve axons
Effect of topical Carbonic anhydrase inhibitor (CAI) on the total protein (TP) concentration in the tear film There were no differences in the TP concentrations in the tear film of patients using topical preservative-free dorzolamide as compared to the group C
The TP concentration was found to be slightly higher in the group of patients using topical benzalkonium chloride (BAC)-preserved medications when compared with group DL as well as with group C, but these differences were not statistically significant (Fig. 1)
Summary
Glaucoma is a group of eye diseases representing a wide spectrum of clinical presentations and etiologies, which can lead to a permanent loss of visual function due to progressive degeneration of the retinal ganglion cells and nerve axons. The only established modifiable risk factor of glaucoma-associated optic neuropathy development is a reduction of elevated intraocular pressure (IOP), which can be obtained using topical eye drops or surgery [1]. Because of the chronic nature of the disease, antiglaucoma medications must be used over a long period. Long-term exposure to the active ingredients and associated preservatives can lead to the development of ocular surface disease (OSD) or aggravate pre-existing abnormalities. OSD is a constellation of disorders affecting the eyelids, conjunctiva and corneal surface, and the signs that appear in its course are largely resemblant to the side effects of antiglaucoma eye drops [2, 3]. Long-term use of topical, especially benzalkonium chloride (BAC)-preserved, antiglaucoma medications can cause a negative impact on the ocular surface. The aim of the study was to assess the effect of topical carbonic anhydrase inhibitors (CAIs) on selected oxidative stress biomarkers in the tear film
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