Ocular Surface Disease Signs and Symptoms in Patients with Pseudoexfoliative Glaucoma: A Case—Control Study

Maria Dermenoudi, A. Matsou, Christina Keskini, E. Anastasopoulos
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Abstract

Purpose: The present study evaluates the differences in the prevalence of the signs and symptoms of ocular surface disease (OSD) in patients with PEX glaucoma (PEXG), compared to other glaucoma types (non-PEXG). Methods: Patients with non-PEXG and PEXG were prospectively examined for the presence and severity of OSD signs and questioned for symptoms using the OSDI (ocular surface disease index) questionnaire. Results: 116 patients were prospectively enrolled (58 non-PEXG and 58 PEXG). PEXG subjects who were older, had lower central corneal thickness (CCT) values, at a more advanced glaucoma stage and required more IOP lowering drops. OSD signs were prevalent in both groups: conjunctival hyperemia (74.5% non-PEXG vs. 94.8% PEXG), eyelid redness (70.7% vs. 96.6%), conjunctival (74.1% vs. 93.1%) and corneal fluorescein staining (81% vs. 93.1%) and abnormal TFBUT (82.8% vs. 87.9%). When adjusted for potential confounders, (older age, thinner CCT, more advanced glaucoma in PEXG) eyelid redness remained the only parameter significantly associated with PEXG, being 11 times more likely to occur in this group (p = 0.037). Conclusion: Subjects with PEXG presented a higher frequency of signs of OSD compared to other glaucoma types. When accounting for confounding factors, the only difference between the groups was the significantly higher presence (11 times more likely) of eyelid redness in PEXG, suggesting, in addition to glaucoma treatment, the impact of PEX on ocular surface integrity.
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假性剥脱性青光眼患者的眼表疾病体征和症状:一项病例对照研究
目的:本研究评估PEX型青光眼(PEX型)患者与其他类型青光眼(非PEX型)相比,眼表疾病(OSD)的体征和症状患病率的差异。方法:采用OSDI(眼表疾病指数)问卷对非PEXG和PEXG患者进行前瞻性检查,检查OSD体征的存在和严重程度,并对症状进行询问。结果:116例患者被纳入前瞻性研究(58例非PEXG和58例PEXG)。PEXG受试者年龄较大,角膜中央厚度(CCT)值较低,青光眼阶段较晚,需要更多的IOP降眼压。OSD症状在两组中都很普遍:结膜充血(74.5%非PEXG vs 94.8% PEXG),眼睑发红(70.7% vs 96.6%),结膜(74.1% vs 93.1%)和角膜荧光素染色(81% vs 93.1%)以及TFBUT异常(82.8% vs 87.9%)。在校正潜在混杂因素后,(年龄较大、CCT较薄、PEXG患者青光眼较晚期)眼睑发红仍然是唯一与PEXG显著相关的参数,在该组中发生的可能性是PEXG的11倍(p = 0.037)。结论:与其他青光眼类型相比,PEXG患者出现OSD体征的频率更高。当考虑到混杂因素时,两组之间的唯一区别是PEX治疗中眼睑发红的发生率明显更高(可能性高出11倍),这表明除了青光眼治疗外,PEX还对眼表完整性有影响。
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