scholarly journals How Ocular Surface Disease Impacts the Glaucoma Treatment Outcome

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Snježana Kaštelan ◽  
Martina Tomić ◽  
Kata Metež Soldo ◽  
Jasminka Salopek-Rabatić
Keyword(s):  
Ocular Surface ◽  
Microbial Contamination ◽  
Standard Form ◽  
Ocular Surface Disease ◽  
Treatment Goals ◽  
Corneal Epithelial ◽  
Glaucoma Treatment ◽  
Preservative Free

The treatment goals for glaucoma are lowering the intraocular pressure and preservation of vision. Topical hypotensive drops are the standard form of therapy which is often associated with some symptoms of toxicity, ocular inflammation, allergy, or ocular surface disease (OSD). OSD is a common comorbidity in glaucoma patients, and its prevalence with glaucoma increases with age. Use of topical treatment could additionally increase symptoms of OSD mostly due to preservatives added to multidose medication bottles used to reduce the risk of microbial contamination. This toxicity has been particularly associated with BAK, the most commonly used preservative which damages conjunctival and corneal epithelial cells and significantly aggravates OSD symptoms. OSD adversely affects patients’ quality of life causing discomfort and problems with vision which in turn may result in noncompliance, lack of adherence, and eventually visual impairment. In the management of glaucoma patients OSD symptoms should not be overlooked. If they are present, topical glaucoma treatment should be adapted by decreasing the amount of drops instilled daily, using BAK-free or preservative-free medication and lubricants if necessary. Awareness of the presence and importance of OSD will in turn improve patients' adherence and compliance and thus ultimately the preservation of long-term vision.

scholarly journals Pharmacoeconomic aspects of glaucoma therapy with prostaglandin analogues in patients with signs of ocular surface disease

2015 ◽  
Vol 8 (1) ◽  
pp. 99-103
Author(s):  
Alla Vsevolodovna Rudakova
Keyword(s):  
Quality Of Life ◽  
Clinical Efficacy ◽  
Ocular Surface ◽  
Negative Impact ◽  
Ocular Surface Disease ◽  
Prostaglandin Analogues ◽  
The Cost ◽  
Ophthalmic Solutions ◽  
Preservative Free

Treatment of glaucoma is prevalent in modern healthcare. The standard of care at this time in the majority of glaucoma patients is to be treated with prostaglandin analogues. The aim of the present study was to compare the cost-effectiveness and the effect on the daily quality of life of preservative-free tafluprost to benzalkonium chloride (BAK) preserved latanoprost ophthalmic solutions which are present on the Russian market. In the patients with signs of ocular surface disease. Material and methods. The cost calculation was carried out on the basis of the weighted average retail price in Moscow from March 2015. The research was carried out over a 1 yeartime period. At the assessment, we assumed that clinical efficacy of the compared drugs did not differ; but at the same time the absence of the negative impact of treatment on patients’ quality of life (QoL), assessed by COMTol questionnaire, was observed in 30 % of patients treated with BAK-preserved latanoprost and in 52 % of patients treated with preservative-free tafluprost. Results and discussion. The costs of glaucoma treatment with preservative-free tafluprost and with branded BAK-preserved latanoprost are now comparable. The cost per 1 patient without the negative impact of treatment on patients’ QoL for tafluprost (Taflotan®) was 42.6 % lower than that for branded latanoprost (Xalatan®), 72.7 % higher than that for the generic latanoprost Glaumax®, and 24.3 % higher than that for the generic latanoprost Latanomol™. The analysis of the results’ sensitivity to changes in the cost of drugs in real limits demonstrated their high reliability. When taking a decision on the reimbursement for prostaglandin analogues, one should be aware that generic latanoprost ophthalmic solutions may differ significantly from the branded drug both in physical and chemical properties as well as in clinical efficacy and safety. Conclusion. Preservative-free tafluprost and branded BAK-preserved latanoprost are characterized by comparable clinical efficacy whereas preservative-free tafluprost has better tolerability. At a comparable cost of treatment, preservative-free tafluprost has a higher cost-effectiveness. This allows recommending its inclusion in regional and federal programs for the treatment of glaucoma in patients with ocular surface disease signs.

scholarly journals Glaucoma and Dry Eye

2021 ◽  
Author(s):  
Mauricio Aguirre Baez ◽  
Rodrigo Castillo Iturria
Keyword(s):  
Chronic Inflammation ◽  
Dry Eye ◽  
Topical Treatment ◽  
Ocular Surface ◽  
Rational Treatment ◽  
Eye Symptoms ◽  
Glaucoma Treatment ◽  
Meibomian Glands ◽  
Preservative Free

Glaucoma treatment is closely related to the appearance or worsening of dry eye symptoms. The current topical treatment produces chronic inflammation that affects globet cells, meibomian glands and cornea, which translates into a decrease in the quantity and quality of the tear. It is characterized by increased osmolarity, which perpetuates damage to the ocular surface. Preservatives currently play a fundamental role in damage the ocular surface. There are numerous studies that have shown their toxic effects on the eye. Currently there are numerous preservative-free formulations and new therapies that allow us to improve the condition of the ocular surface in patients with glaucoma. A rational treatment is proposed using the different approaches available in the literature.

Comparison of Ocular Surface Cytological Appearance in Glaucoma Patient Treated with Timolol Maleat 0,5% Latanoprost 0,005% and Timolol-Latanoprost Fixed Combination Preservative Free Eye Drop

2019 ◽  
Vol 44 (2) ◽  
pp. 82
Author(s):  
Maretha Amrayni ◽  
Elsa Gustianty ◽  
Susi Heryati ◽  
Andika Prahasta ◽  
Maula Rifada ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Cell Density ◽  
Goblet Cell ◽  
Ocular Surface ◽  
Fixed Combination ◽  
Cell Contact ◽  
Corneal Epithelial ◽  
Preservative Free ◽  
Goblet Cell Density ◽  
Epithelial Metaplasia

Introduction : The longterm use of topical antiglaucoma might cause ocular surface instability due to active substance or preservative used. Impression cytology examination may reveal superficial epithelial cells on conjunctiva and cornea, including goblet cells. Goblet cell density decrease is the most important parameter on evaluation of ocular surface disorder. Objective : This study was to understand ocular surface remodeling due to active substance of topical antiglaucoma with impression cytology examination among the patient prior and 3 months after therapy. Methods : This was a randomized controlled trial study with single blind masking. A total of 45 eyes from 31 patients were used as subject and distributed onto three groups treatment, which were timolol maleat 0.5%, latanoprost 0.005%, and latanoprost-timolol maleat fixed combination. All topical antiglaucoma in this study were preservative free. Result : There were differences between 3 groups in goblet cells density after 3 months therapy (p=0,030). Goblet cell density in timolol group was lower than latanoprost (p=0,041) and fixed combination (p=0,045). There was no significantly difference between 3 groups in conjunctival epithelial metaplasia degree (p=0,706) and cell to cell contact degree in corneal epithelial cells (p=0.66) after 3 months therapy. Conjunctival epithelial metaplasia degree were increased among group of timolol (p=0,008) and fixed combination (p=0,046). Conclusion : Timolol maleat 0,5% caused lower goblet cell density after 3 months therapy compare with latanoprost and fixed combination. There was no significantly difference in conjunctival epithelial metaplasia and cell to cell contact degree in corneal epithelial cells among these glaucoma treatment groups.

Long-term Progression of Ocular Surface Disease in Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis

Cornea ◽  
2020 ◽  
Vol 39 (6) ◽  
pp. 745-753
Author(s):  
Yamato Yoshikawa ◽  
Mayumi Ueta ◽  
Hideki Fukuoka ◽  
Tsutomu Inatomi ◽  
Isao Yokota ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Ocular Surface ◽  
Ocular Surface Disease ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome

The crystal arthropathies

2013 ◽  
Vol 6 (11) ◽  
pp. 681-687 ◽  
Author(s):  
Robert A Jones ◽  
Brian Quilty
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Inflammatory Arthritis ◽  
Term Treatment ◽  
Routine Practice ◽  
Treatment Goals ◽  
Crystal Arthropathies ◽  
Long Term Treatment

Unlike many other forms of inflammatory arthritis, the crystal arthropathies are routinely diagnosed and managed in primary care. Gout, in particular, is relatively commonplace and rates of other types of crystal-related arthritis are predicted to increase. These are, therefore, conditions that GPs and trainees will regularly encounter during routine practice. While the clinical features and pathophysiology of gout and pseudo-gout are well described, the long-term treatment goals and options of management are often less well understood, and opportunities to assess for associated co-morbidities can easily be missed. GPs can be central in optimising management by promptly and appropriately addressing acute symptoms, preventing recurrent attacks, minimising disability and work absences, reducing cardiovascular risk factors, improving general health and enhancing quality of life.

scholarly journals Diagnosis and Treatment Methods for Ocular Surface Disease in Glaucoma

2014 ◽  
Vol 08 (01) ◽  
pp. 40
Author(s):  
Gemma C M Rossi ◽  
Keyword(s):  
Ocular Surface ◽  
Diagnostic Tests ◽  
Benzalkonium Chloride ◽  
Tear Film ◽  
Daily Practice ◽  
Ocular Surface Disease ◽  
Anterior Surface ◽  
Treatment Methods ◽  
Associated Diseases

Glaucoma and ocular surface disease (OSD) are often concomitant disorders (OSD is the consequence of a tear film dysfunction that may be due to several conditions). The aims of the paper are to suggest a sequence of diagnostic tests easy to perform in daily practice, both subjective and objective, to detect the onset of the OSD; and, second, to propose how to prevent and, if the case, how to manage the OSD. Briefly, tear film break-up time (TF-BUT) and corneal/conjunctival staining are suggested to detect the main signs of OSD. In terms of therapy, the long-term exposure to benzalkonium chloride (BAK) should be minimised, preferring non-BAK-preserved or BAK-free glaucoma medications, where available, as well as fixed combinations. The treatment of associated diseases of the anterior surface may reduce signs; use of non BAK-preserved tears may reduce symptoms.

Cultivated Corneal Epithelial Transplantation for Severe Ocular Surface Disease in Vernal Keratoconjunctivitis

Cornea ◽  
2005 ◽  
Vol 24 (4) ◽  
pp. 426-430 ◽  
Author(s):  
Virender S Sangwan ◽  
Somasheila I Murthy ◽  
Geeta K Vemuganti ◽  
Aashish K Bansal ◽  
Nibaran Gangopadhyay ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Ocular Surface Disease ◽  
Vernal Keratoconjunctivitis ◽  
Corneal Epithelial

scholarly journals Effect of Autologous Serum Eyedrops on Ocular Surface Disease Caused by Preserved Glaucoma Eyedrops

2020 ◽  
Vol 9 (12) ◽  
pp. 3904
Author(s):  
Ha-Rim So ◽  
Hae Young Lopilly Park ◽  
So-Hyang Chung ◽  
Hyun-Seung Kim ◽  
Yong-Soo Byun
Keyword(s):  
Ocular Surface ◽  
Ocular Surface Disease ◽  
Autologous Serum ◽  
Ocular Surface Disease Index ◽  
Ocular Surface Diseases ◽  
Group 3 ◽  
Baseline Values ◽  
Group 2 ◽  
Group 1

Autologous serum eyedrops (ASE) are effective in treating various ocular surface diseases, including damages induced by long-term use of preserved glaucoma eyedrops. However, there has been no study on whether ASE is effective without stopping the causative eyedrops. This retrospective observational study included 55 patients with ocular-surface diseases caused by long-term use of preserved glaucoma eyedrops: 18 patients who used ASEs for 2 months without discontinuing the use of glaucoma eyedrops (Group 1), 22 patients who used ASEs for 2 months, discontinuing the use of glaucoma eyedrops for the first month (Group 2) and 15 patients who used non-preservative artificial tears for 2 months, discontinuing the use of glaucoma eyedrops for the first month (Group 3). There were no intergroup differences in the baseline values of the Schirmer I test results, tear breakup time (TBUT), ocular surface staining (OSS) score, loss of the meibomian gland, meibum quality and ocular-surface disease index (OSDI). Group 1 showed significant differences in TBUT, OSS score and OSDI at 2 months when compared to the baseline values before treatment, while Group 2 showed significant differences in those values at both 1 and 2 months. There were no differences in any of the parameters at baseline, 1 month or 2 months in Group 3. Our result suggested that ASE is effective for treating ocular surface diseases caused by glaucoma eyedrops containing preservatives and its effects can be expected without interruption of glaucoma eyedrop treatment.

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