Posters

BAK effect in ocular surface disease occurrence

Poster Details

First Author: M. Radenkovic SERBIA

Co Author(s): G. Stankovic-Babic   P. Jovanovic   J. Djordjevic-Jocic   M. Zivkovic   M. Trenkic-Bozinovic   M. Petrovic     

Abstract Details

Purpose:

Ocular Surface Disease(OSD) is multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbances,tear film instability with damage to the ocular surface, accompanied by increased tear film osmolarity and inflammation. Prevalence is higher in glaucoma patients (40-60%). Antiglaucoma topical therapy cause exacerbation/occurence of symptoms of dry eye due to main substances or preservatives (benzalkonium-BAK), dose and time dependent. BAK reduces the stability of the lipid layer of tears, number of goblet cells, induces apoptosis and inflammatory infiltration. Healthy eye surface is essential finding in drug treatment, surgery and refractive outcome.

Setting:

These research(patient examination) was performed in glaucoma department of Eye Clinic (ClinicalCentreNis)-to estimate OSD incidence between glaucoma patients after topical drug application due to preservative BAK that results in symptoms of discomfort, tear film instability and potential damage of the ocular surface.

Methods:

Performed statistic analysis (SPSS18; 2 test) of examined:140 glaucoma patients(POAG;XFG) and 90 healthy subjects. Examination tool: TBUT, Schirmer test, Delphi Panel grading scale and type of OSD. Grade and type of OSD was observed due to BAK concentration, number (bottles) of drugs, therapy duration, type of glaucoma. Control group was without eye diseases or any kind of topical therapy including artefitial tears.

Results:

Glaucoma patients were older than healty ones(p<0,001).Between 140 OAG patients: 99POAG and 41XFG patients, previously treated by different number of drugs/bottles that contains different BAK concentrations as preservative. 37% of patients used 1(POAG) or 2 bottles(XFG) and 25% used 3 bottles od drugs.81% had therapy less than 5 years and 13% less than 10 years.Among OAG 64% had mixtus and evaporative type of OSD vs.64% normal in health group that correlates to higher BAKconcentrations.87% XFG had OSD(p<0,005). Highest BAK concentrations were find in mixtus OSD in POAG(p<0,005). Most prevalent is IIb grade concomitant to higher BAK(p<0,01).

Conclusions:

Manifestation of symptoms and signs of OSD depends on the duration of glaucoma therapy and number of antiglaucoma agents. According to the OSD type, mixtus and evaporative dry eye are most prevalent, higher in XFG and correlates to BAK concentration. The most prevalent time interval of applied antiglaucoma drugs was between one and five years.Timely diagnoses and treatment of OSD is very important concerning patients quality of life, including indication for surgery in acheiving successful surgical and refractive outcome.

Financial Disclosure:

None