Expert Consensus Recommendations for the Management of Ocular Surface Inflammation in Patients With Glaucoma.

IF 2 4区医学 Q2 OPHTHALMOLOGY Journal of Glaucoma Pub Date : 2024-10-01 Epub Date: 2024-07-18 DOI:10.1097/IJG.0000000000002465

Elisabeth M Messmer, Christophe Baudouin, José-Manuel Benitez-Del-Castillo, Michele Iester, Alfonso Anton, John Thygesen, Fotis Topouzis

{"title":"Expert Consensus Recommendations for the Management of Ocular Surface Inflammation in Patients With Glaucoma.","authors":"Elisabeth M Messmer, Christophe Baudouin, José-Manuel Benitez-Del-Castillo, Michele Iester, Alfonso Anton, John Thygesen, Fotis Topouzis","doi":"10.1097/IJG.0000000000002465","DOIUrl":null,"url":null,"abstract":"Prcis: We have developed through a consensus process 24 clinical recommendations for the comprehensive management of ocular surface inflammation in glaucoma patients, including diagnostic criteria, prevention measures, and treatment strategies according to ocular surface disease severity.Purpose: To obtain expert consensus on the diagnosis, prevention, and management of ocular surface inflammation (OSI) in patients with glaucoma.Methods: An international steering committee of glaucoma and/or ocular surface disease (OSD) experts and a wider faculty of members from the Educational Club of Ocular Surface and Glaucoma (ECOS-G) collaborated to develop clinical recommendations on best practice in the management of OSI in glaucoma patients using a nonanonymous interactive quasi-Delphi process. Clinical recommendations were formulated by the steering committee based on an analysis of the recent literature to determine unmet needs, together with a web-based interactive survey of faculty members' opinion in seven identified areas of OSI management in glaucoma. Topics included (1) diagnosis of OSD, (2) diagnosis of OSI, (3) causes of OSI, (4) impact of OSD/OSI, (5) prevention of OSI, (6) treatment of OSI, and (7) inflammation and the deep structures of the eye. Faculty members were invited to vote on the clinical recommendations, and the steering committee then determined whether consensus had been achieved.Results: Consensus was obtained on 24 clinical recommendations by 80%-100% of faculty members. There was consensus that OSI should be investigated in all glaucoma patients. The main prevention measure in glaucoma patients with pre-existing OSD was the elimination/minimisation of preserved medications, especially BAK-preserved eye drops. A subtractive treatment strategy rather than an additive strategy is recommended according to OSI/OSD severity to improve the ocular health and/or before glaucoma surgery.Conclusion: These recommendations for the management of OSI in glaucoma should be useful to guide decision-making in clinical practice.","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"715-727"},"PeriodicalIF":2.0000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Glaucoma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/IJG.0000000000002465","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/18 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Prcis: We have developed through a consensus process 24 clinical recommendations for the comprehensive management of ocular surface inflammation in glaucoma patients, including diagnostic criteria, prevention measures, and treatment strategies according to ocular surface disease severity.

Purpose: To obtain expert consensus on the diagnosis, prevention, and management of ocular surface inflammation (OSI) in patients with glaucoma.

Methods: An international steering committee of glaucoma and/or ocular surface disease (OSD) experts and a wider faculty of members from the Educational Club of Ocular Surface and Glaucoma (ECOS-G) collaborated to develop clinical recommendations on best practice in the management of OSI in glaucoma patients using a nonanonymous interactive quasi-Delphi process. Clinical recommendations were formulated by the steering committee based on an analysis of the recent literature to determine unmet needs, together with a web-based interactive survey of faculty members' opinion in seven identified areas of OSI management in glaucoma. Topics included (1) diagnosis of OSD, (2) diagnosis of OSI, (3) causes of OSI, (4) impact of OSD/OSI, (5) prevention of OSI, (6) treatment of OSI, and (7) inflammation and the deep structures of the eye. Faculty members were invited to vote on the clinical recommendations, and the steering committee then determined whether consensus had been achieved.

Results: Consensus was obtained on 24 clinical recommendations by 80%-100% of faculty members. There was consensus that OSI should be investigated in all glaucoma patients. The main prevention measure in glaucoma patients with pre-existing OSD was the elimination/minimisation of preserved medications, especially BAK-preserved eye drops. A subtractive treatment strategy rather than an additive strategy is recommended according to OSI/OSD severity to improve the ocular health and/or before glaucoma surgery.

Conclusion: These recommendations for the management of OSI in glaucoma should be useful to guide decision-making in clinical practice.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

青光眼患者眼表炎症管理专家共识建议》。

摘要目的：就青光眼患者眼表炎症（OSI）的诊断、预防和管理达成专家共识：方法：由青光眼和/或眼表面疾病（OSD）专家组成的国际指导委员会与眼表和青光眼教育俱乐部（ECOS-G）成员组成的更广泛的教师团队合作，采用非匿名互动式准德尔菲流程，就青光眼患者眼表炎症（OSI）管理的最佳实践制定临床建议。临床建议由指导委员会根据对近期文献的分析制定，以确定尚未满足的需求，同时对教职员工在青光眼 OSI 管理的七个已确定领域的意见进行网络互动调查。调查主题包括：1）OSD 的诊断；2）OSI 的诊断；3）OSI 的原因；4）OSD/OSI 的影响；5）OSI 的预防；6）OSI 的治疗；7）炎症和眼球深部结构。教职员工应邀对临床建议进行投票，然后由指导委员会决定是否达成共识：结果：80%-100%的教师就 24 项临床建议达成了共识。大家一致认为，所有青光眼患者都应接受 OSI 检查。对于已有 OSD 的青光眼患者，主要的预防措施是停用或尽量少用防腐药物，尤其是 BAK 防腐滴眼液。建议根据OSI/OSD的严重程度采取减法治疗策略，而不是加法治疗策略，以改善眼部健康和/或在青光眼手术前进行治疗：这些关于青光眼 OSI 管理的建议应有助于指导临床实践中的决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of Glaucoma 医学-眼科学

CiteScore

4.20

自引率

10.00%

发文量

330

审稿时长

4-8 weeks

期刊介绍： The Journal of Glaucoma is a peer reviewed journal addressing the spectrum of issues affecting definition, diagnosis, and management of glaucoma and providing a forum for lively and stimulating discussion of clinical, scientific, and socioeconomic factors affecting care of glaucoma patients.