Título

EVALUATION OF OCULAR SURFACE DISEASE IN PATIENTS WITH GLAUCOMA: CLINICAL PARAMETERS, SELF-REPORT ASSESSMENT AND OBJECTIVE KERATOGRAPH ANALYSIS

Objetivo

To assess the ocular surface disease (OSD) in patients with glaucoma who used topical intraocular pressure-lowering therapies and to compare with a group of patients with cataract who were not using topical intraocular pressure-lowering therapies.

Método

A comparative cross-sectional study was carried out. Only glaucomatous patients who were using at least 1 topical IOP-lowering medication for at least 6 months were included. Ocular surface disease was evaluated using tear break-up time (TBUT),corneal fluorescein staining (conjunctival hyperemia), biomicroscopy (presence/absence of keratitis), and Ocular Surface Disease Index (OSDI) questionnaire. All patients underwent computerized keratograph analysis, (non-invasive BUT, meibography quantification, tear meniscus height,and redness scale). Different clinical and keratograph parameters were compared between glaucoma and control groups.

Resultado

A total of 15 glaucoma patients and 12 controls were included.Glaucoma patients had worse conjunctival hyperemia and more keratitis compared to control group (p≤=0.031). According to OSDI questionnaire,the overall OSD prevalence rate was 44% control vs 56% glaucoma group (P=0.031). Glaucoma group had significant worse scores in the OSDI questionnaire compared to cataract group (9.17±2.49 vs. 16.33±2.06, respectively; P=0.035). For the objective keratograph assessment,glaucoma group had significant higher hyperemia indexes compared to controls (2.26±0.49 vs. 1.71±0.13; p=0.009). Non-invasive keratograph BUT index was worse (10.19±6.93 vs. 16.81±7.50; p=0.036),and tear meniscus height was smaller in eyes with glaucoma (0.22±0.05 vs. 0.26±0.03; p=0.031).

Conclusão

There is a significant difference between conjunctival hyperemia,presence of keratitis and total scores in OSDI questionnaire,as well as objective parameters measured by keratograph in glaucoma group compared to control group. These findings indicate that patients with glaucoma may have significant clinical symptoms for OSD and these are related with the treatment.