Ocular Surface Disease and Glaucoma Medications: A Clinical Approach.
Ocular Surface Disease and Glaucoma Medications: A Clinical Approach.
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DOI：
10.1097/icl.0000000000000544
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发表时间：
2019-01
期刊：
影响因子：
--
通讯作者：
Saeedi O
中科院分区：
文献类型：
--
作者：
Zhang X;Vadoothker S;Munir WM;Saeedi O
眼表疾病经常与青光眼共存，并且可能因局部青光眼药物而引发或加剧。我们对当前文献进行了回顾，以评估青光眼患者眼表疾病的患病率、原因和治疗，特别是那些接受局部治疗的患者。进行了 Pubmed 数据库检索。 1972年至2018年间，共发现720篇与眼表疾病、青光眼和青光眼药物相关的文章。其中，102 篇文章纳入本次分析。我们纳入了针对局部青光眼药物治疗患者的初步研究和实证研究。排除标准包括病例报告、非英语研究以及与本综述主要主题无关的文章。根据诊断测试（包括临床检查和问卷调查）评估正常眼和青光眼眼的眼表疾病，以确定视功能和生活质量。青光眼药物可能与眼表毒性有关，最常见的原因是药物中所含防腐剂的性质；然而，通过使用不含防腐剂的药物、减少防腐剂药物或治疗干眼病可以减轻毒性的发生率。采用激光小梁成形术或不损伤结膜和角膜的微创青光眼手术治疗青光眼，可以避免或减少对局部青光眼药物的依赖，从而有可能避免眼表疾病的发生或进展。青光眼患者眼表疾病的识别和治疗可以改善患者的生活质量和药物依从性。这可能最终改善青光眼的治疗结果。
Ocular surface disease frequently co-exists with glaucoma and may be initiated or exacerbated by topical glaucoma medications. We performed a review of current literature to assess the prevalence, causes, and treatment of ocular surface disease in glaucoma patients, specifically those on topical therapy. A Pubmed database search was conducted. A total of 720 articles published from 1972 to 2018 were found in relation to ocular surface disease, glaucoma, and glaucoma medications. Of these, 102 articles were included in this analysis. We included primary and empirical studies for patients on topical glaucoma medications. Exclusion criteria included case reports, non-English studies, and articles unrelated to the primary subject of this review. Ocular surface disease among normal and glaucomatous eyes was evaluated based on diagnostic testing including clinical exam and questionnaires to determine visual function and quality of life. Glaucoma medications can be associated with toxicities to the ocular surface, most often due to the nature of the preservative included in the medication; however, the incidence of toxicity can be mitigated by the use of preservative free medications, decreased preservative medications, or treatment of dry eye disease. Treatment of glaucoma with laser trabeculoplasty or minimally invasive glaucoma surgeries that spare the conjunctiva and the cornea may avoid or decrease reliance on topical glaucoma medications, potentially avoiding the initiation or progression of ocular surface disease. Recognition and treatment of ocular surface disease in glaucoma patients may improve patient quality of life and medication adherence. This may ultimately improve glaucoma treatment outcomes.