Patients treated with anti-glaucoma medications have significant meibomian gland dropout, and the effect is proportional to the number of medications and instillations per day, according to a study.
Thirty healthy eyes of 30 subjects and 85 eyes of 85 subjects with glaucoma under different dosages and instillation regimens of IOP-lowering medications were included.
For each eye, slit lamp examination, tear break-up time, lipid interferometry, blinking video recording, Schirmer’s test and meibography were performed. All subjects completed the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, designed to assess the frequency and severity of dry eye symptoms in meibomian gland dysfunction. For each glaucoma patient, the burden of anti-glaucoma regimen (BAG) score was determined in relation to the type, number, instillation times per day and total monthly instillations of IOP-lowering medications.
Patients with glaucoma were found to have significantly lower SPEED scores than healthy participants, and a significant correlation between BAG score and meibomian gland loss was found. The higher burden group had significantly more severe meibomian gland dropout, lower meibomian gland density and meibomian gland loss ratio, while meibum quality, meibomian gland expressibility and meibomian gland secretion did not significantly differ between groups.
“This scoring system can be easily applied in the clinical practice to monitor the cumulative anti-glaucoma burden during follow-up and helps physicians consider meibomian gland and ocular surface disease as a possible sequelae of topical treatment,” the authors wrote.
They also pointed out that further studies are needed to clarify whether the cumulative dosage effect is induced by the active ingredients of glaucoma medications or by the preservatives. – by Michela Cimberle
Disclosure: The authors reported no conflict of interest