Kocaeli Med J. 2016; 5(1): 6-10

Prevalence of ocular surface disease in glaucoma patients

Ruken Çinik¹, Nurþen Yüksel², Dilara Pirhan^2
1Department of Ophthalmology, Özel Gölcük Medical Centre, Kocaeli, Turkey
²Department of Ophthalmology, Kocaeli University, Kocaeli, Turkey

INTRODUCTION: To evaluate the prevalence of ocular surface disease (OSD) in glaucoma patients.
METHODS: 173 eyes of 88 patients aged 17 years or older with primary open angle glaucoma (POAG), pseudoexfoliation glaucoma (PEG) and ocular hypertension (OHT) were enrolled in the study. Each patient completed for Ocular Surface Disease Index (OSDI) questionaire, and underwent evaluation by Schirmer test, conjunctival and corneal Lissamine green (LG) dye test and tear break-up time (TBUT).
RESULTS: Using the OSDI survey dry eye symptoms were assessed. Symptoms were reported in 137 eyes (79%) and in 68 (39%) severe symptoms were recorded. Schirmer testing showed decreased tear production in 91 eyes (52.6%). Severe tear deficiency was detected in 31 (17.9%) eyes. LG staining showed positive results in117 (67.6%) patients, 6 (3.4%) had severe staining. TBUT demonstrated abnormal tear quality in 146 (84%) patients and severe decrease in tear quality was found in 69 (39.8%) patients. There was a significant difference between OSD symptoms and signs and the use of BAK-containing eyedrops. The results of the LG dye test and OSDI revealed that there was also a correlation with number of the drugs used in addition to the use of BAK-containing drug.
DISCUSSION AND CONCLUSION: In the majority of patients with POAG, PEG and OHT symptoms of OSD and/or findings were detected. The combination of OSD and BAK-containing eyedrops use significantly affects the quality of tear in this patient population.

Keywords: Benzalkonium chloride, Glaucoma, Dry eye, Ocular surface disease

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Glokom hastalarýnda oküler yüzey hastalýk prevalansý

Ruken Çinik¹, Nurþen Yüksel², Dilara Pirhan^2
1Özel Gölcük Aile Týp Merkezi, Göz Hastalýklarý Bölümü, Kocaeli
²Kocaeli Üniversitesi Týp Fakültesi, Göz Hastalýklarý Ana Bilim Dalý, Kocaeli

GÝRÝÞ ve AMAÇ: Glokom hastalarýnda oküler yüzey hastalýk (OYH) prevalansýnýn deðerlendirilmesi
YÖNTEM ve GEREÇLER: 17 yaþ ve üzerinde, primer açýk açýlý glokom (PAAG), psödoeksfoliatif glokom (PEG) ve okuler hipertansiyonu (OHT) olan 88 hastanýn 173 gözü çalýþma kapsamýna alýndý. Her hasta oküler yüzey hastalýk indeksi (OSDI), schirmer testi, konjonktival ve korneal lissamin yeþili (LY) boya testi ve gözyaþý kýrýlma zamaný (GKZ) ile deðerlendirildi.
BULGULAR: OSDI anketi kullanýlarak kuru göz semptomlarý deðerlendirilen hastalarýn 137 gözünde (%79) semptom rapor edildi, 68’inde (%39) þiddetli semptomlarýn olduðu raporlandý. Schirmer testi, 91 gözde (%52.6) gözyaþý yapýmýnýn azaldýðýný gösterdi. Þiddetli gözyaþý eksikliði 31 gözde (%17.9) saptandý. LY boyamasý gözlerin 117 (%67.6)’sinde pozitif sonuç verdi, 6 (%3.4) gözde ise þiddetli boyanma mevcuttu. GKZ gözlerin 146 (%84)’sýnda gözyaþý kalitesinde bozulma olduðunu ve 69 (%39.8)’unda gözyaþý kalitesinde þiddetli azalma olduðunu gösterdi. Benzalkonium chloride (BAK) içerikli göz damlasý kullanmayan hasta grubunda damla kullanan gruba göre OYH testlerinde anlamlý fark tespit edildi. LY boya testi ve OSDI sonuçlarýnýn ilaç kullanýmýnýn yanýsýra kullanýlan ilaç sayýsý ile de korelasyon gösterdiði saptandý.
TARTIÞMA ve SONUÇ: PAAG, PEG ve OHT olan hastalarýn büyük bir kýsmýnda oküler yüzey hastalýk belirti ve/veya bulgusu saptandý. OYH ve BAK içerikli göz damlasý kullanýmý birlikteliðinin bu hasta popülasyonunda gözyaþý kalitesini belirgin þekilde etkilediði tespit edildi.

Anahtar Kelimeler: Benzalkonyum klorid, Glokom, Kuru göz, Oküler yüzey hastalýðý

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