IOP-lowering therapy and ocular surface in glaucoma. Part 1. The effects of drug substances of glaucoma medications on the ocular surface

<p> <b>A.V. Antonova<sup>1</sup>, V.P. Nikolaenko<sup>1,2</sup>, V.V. Brzheskiy<sup>3</sup></b><br> </p> <p> <b><sup>1</sup>City Multidisciplinary Hospital No. 2, St. Petersburg, Russian Federation</b>...

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Main Authors: A.V. Antonova, V.P. Nikolaenko, V.V. Brzheskiy
Format: Article
Language:Russian
Published: Prime-Media 2020-06-01
Series:РМЖ "Клиническая офтальмология"
Online Access:http://clinopht.com/upload/iblock/c97/c97e9ce01e5ca9962337fdf32f9868c3.pdf
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author A.V. Antonova
V.P. Nikolaenko
V.V. Brzheskiy
author_facet A.V. Antonova
V.P. Nikolaenko
V.V. Brzheskiy
author_sort A.V. Antonova
collection DOAJ
description <p> <b>A.V. Antonova<sup>1</sup>, V.P. Nikolaenko<sup>1,2</sup>, V.V. Brzheskiy<sup>3</sup></b><br> </p> <p> <b><sup>1</sup>City Multidisciplinary Hospital No. 2, St. Petersburg, Russian Federation</b> </p> <p> <b><sup>2</sup>St. Petersburg State University, St. Petersburg, Russian Federation</b> </p> <p> <b><sup>3</sup>St. Petersburg State Pediatric Medical University, St. Petersburg, Russian Federation</b> </p> <p> <i>This article reviews recent data on the effect of active ingredients and preservatives of IOP-lowering medications on the ocular surface. The rate and severity of ocular surface disease depend on the intensity and duration of glaucoma treatment as well as baseline ocular surface status. In addition, each class of IOP-lowering medications is characterized by specific effects on ocular surface. Long-term pharmacotherapy results in tear film instability and tear hyperosmolarity. Dose- and exposition-dependent loss of goblet cells, corneal epithelial toxicity, meibomian gland dysfunction, increased activity and expansion of fibroblasts, and pro-inflammatory cytokine release from goblet cells account for the development and progression of symptoms and signs of dry eye as demonstrated by progressive deterioration in Ocular Surface Disease Index (OSDI), Norn’s test, and Schirmer’s test. The result is poor adherence to medical treatment and poor outcomes&nbsp; of conjunctival glaucoma surgery.&nbsp;</i> </p> <p> <i>Our findings can be applied to develop perioperative management strategy of patients with glaucoma to maximize the chances of long-term surgical success.</i> </p> <p> <i><b>Keywords</b>: glaucoma, IOP-lowering treatment, ocular surface, dry eye disease, Ocular Surface Disease Index, inflammation, preservatives, benzalkonium chloride, preservative-free medication.</i> </p> <p> <i><b>For citation: </b>Antonova A.V., Nikolaenko V.P., Brzheskiy V.V. IOP-lowering therapy and ocular surface in glaucoma. Part 1. The effects of drug substances of glaucoma medications on the ocular surface. Russian Journal of Clinical Ophthalmology. 2020;20(2):79–84. DOI: 10.32364/2311-7729-2020-20-2-79-84.</i> </p> <i><br> </i><br>
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institution Kabale University
issn 2311-7729
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publishDate 2020-06-01
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record_format Article
series РМЖ "Клиническая офтальмология"
spelling doaj-art-1deeb102b1134509822c38b0e6e9bf9f2025-01-16T09:39:39ZrusPrime-MediaРМЖ "Клиническая офтальмология"2311-77292619-15712020-06-0120231091IOP-lowering therapy and ocular surface in glaucoma. Part 1. The effects of drug substances of glaucoma medications on the ocular surfaceA.V. Antonova0V.P. Nikolaenko1V.V. Brzheskiy2Russian Journal of Clinical Ophthalmology, Publisher of «Medicina-Inform» Address for correspondence: Russia, 105064, Moscow, P.O. Box 399Russian Journal of Clinical Ophthalmology, Publisher of «Medicina-Inform» Address for correspondence: Russia, 105064, Moscow, P.O. Box 399Russian Journal of Clinical Ophthalmology, Publisher of «Medicina-Inform» Address for correspondence: Russia, 105064, Moscow, P.O. Box 399<p> <b>A.V. Antonova<sup>1</sup>, V.P. Nikolaenko<sup>1,2</sup>, V.V. Brzheskiy<sup>3</sup></b><br> </p> <p> <b><sup>1</sup>City Multidisciplinary Hospital No. 2, St. Petersburg, Russian Federation</b> </p> <p> <b><sup>2</sup>St. Petersburg State University, St. Petersburg, Russian Federation</b> </p> <p> <b><sup>3</sup>St. Petersburg State Pediatric Medical University, St. Petersburg, Russian Federation</b> </p> <p> <i>This article reviews recent data on the effect of active ingredients and preservatives of IOP-lowering medications on the ocular surface. The rate and severity of ocular surface disease depend on the intensity and duration of glaucoma treatment as well as baseline ocular surface status. In addition, each class of IOP-lowering medications is characterized by specific effects on ocular surface. Long-term pharmacotherapy results in tear film instability and tear hyperosmolarity. Dose- and exposition-dependent loss of goblet cells, corneal epithelial toxicity, meibomian gland dysfunction, increased activity and expansion of fibroblasts, and pro-inflammatory cytokine release from goblet cells account for the development and progression of symptoms and signs of dry eye as demonstrated by progressive deterioration in Ocular Surface Disease Index (OSDI), Norn’s test, and Schirmer’s test. The result is poor adherence to medical treatment and poor outcomes&nbsp; of conjunctival glaucoma surgery.&nbsp;</i> </p> <p> <i>Our findings can be applied to develop perioperative management strategy of patients with glaucoma to maximize the chances of long-term surgical success.</i> </p> <p> <i><b>Keywords</b>: glaucoma, IOP-lowering treatment, ocular surface, dry eye disease, Ocular Surface Disease Index, inflammation, preservatives, benzalkonium chloride, preservative-free medication.</i> </p> <p> <i><b>For citation: </b>Antonova A.V., Nikolaenko V.P., Brzheskiy V.V. IOP-lowering therapy and ocular surface in glaucoma. Part 1. The effects of drug substances of glaucoma medications on the ocular surface. Russian Journal of Clinical Ophthalmology. 2020;20(2):79–84. DOI: 10.32364/2311-7729-2020-20-2-79-84.</i> </p> <i><br> </i><br>http://clinopht.com/upload/iblock/c97/c97e9ce01e5ca9962337fdf32f9868c3.pdf
spellingShingle A.V. Antonova
V.P. Nikolaenko
V.V. Brzheskiy
IOP-lowering therapy and ocular surface in glaucoma. Part 1. The effects of drug substances of glaucoma medications on the ocular surface
РМЖ "Клиническая офтальмология"
title IOP-lowering therapy and ocular surface in glaucoma. Part 1. The effects of drug substances of glaucoma medications on the ocular surface
title_full IOP-lowering therapy and ocular surface in glaucoma. Part 1. The effects of drug substances of glaucoma medications on the ocular surface
title_fullStr IOP-lowering therapy and ocular surface in glaucoma. Part 1. The effects of drug substances of glaucoma medications on the ocular surface
title_full_unstemmed IOP-lowering therapy and ocular surface in glaucoma. Part 1. The effects of drug substances of glaucoma medications on the ocular surface
title_short IOP-lowering therapy and ocular surface in glaucoma. Part 1. The effects of drug substances of glaucoma medications on the ocular surface
title_sort iop lowering therapy and ocular surface in glaucoma part 1 the effects of drug substances of glaucoma medications on the ocular surface
url http://clinopht.com/upload/iblock/c97/c97e9ce01e5ca9962337fdf32f9868c3.pdf
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