背景:青光眼相关干眼病(DED)经常被低估,但它是一个重要的共病影响40%至59%的青光眼患者。它可能是预先存在的疾病的恶化或在开始局部用药后开始的新疾病。药物的累积效应,防腐剂和赋形剂导致泪膜组成和眼表稳定性的改变。这项调查的主要目的是研究一组葡萄牙青光眼患者关于DED症状的存在,并将症状的严重程度与不同类型的青光眼局部药物的使用相关联。
方法:这是一项针对诊断为原发性和继发性开角型青光眼的患者的横断面观察性研究。在UnidadeLocaldeSaúdeEntreDouroeVouga的青光眼科,患者随后进行了翻译成葡萄牙语(SPEED-Vp)的标准化患者眼干评估问卷,圣玛丽亚·达·费拉,葡萄牙。收集了关于他们年龄的数据,性别,使用的局部药物类型以及使用的频率和持续时间。进行统计分析。
结果:共有75名患者回答了SPEED-Vp问卷。平均年龄为72±7岁。52%(n=39)是男性,48%(n=36)为女性患者。约49.33%(n=37)使用降低眼压(IOP)的滴眼液超过五年。约61.43%(n=43)的患者使用含防腐剂的降眼压滴眼液。大多数患者使用前列腺素类似物(75.71%,n=53)和β受体阻滞剂(72.86%,n=51)。SPEED评分平均为2.75。约25.33%(n=19)没有DED症状,58.67%(n=44)有轻度症状,8%(n=6)有中度症状,8%(n=6)有严重症状。SPEED评分与年龄无统计学意义的相关性,性别,眼药水容器的数量,许多积极的原则,应用频率,防腐剂的存在,含有防腐剂的滴眼液容器的数量,眼药水使用或任何药物组的持续时间。
结论:虽然大部分患者服用防腐剂滴眼液,这种低的症状率可能是因为患者倾向于降低这些症状;已经在用人工泪液治疗;或者由于神经元角膜神经反应和密度降低而低估了干眼症的感觉。这些结果令人惊讶地积极。这也可能是医疗保健提供者对此问题敏感的结果(早期诊断,人工泪液的早期处方,并从防腐剂改为无防腐剂药物)。
BACKGROUND: Glaucoma-related dry eye disease (DED) is often underestimated, but it is an important comorbidity affecting 40% to 59% of glaucoma patients. It may be an exacerbation of a pre-existing condition or a novel disease starting after the initiation of topical medication. The cumulative effect of medication, preservatives and excipients leads to an alteration in tear film composition and ocular surface stability. The main purpose of this investigation was to study a group of Portuguese glaucoma patients regarding the presence of DED symptoms and correlate the severity of the symptoms with the usage of different types of glaucoma topical medications.
METHODS: This is a cross-sectional observational study of patients diagnosed with primary and secondary open-angle glaucoma. The questionnaire Standardized Patient Evaluation of Eye Dryness (SPEED) translated to Portuguese (SPEED-Vp) was taken by patients followed in the Glaucoma Department of Unidade Local de Saúde Entre Douro e Vouga, Santa Maria da Feira, Portugal. Data was collected regarding their age, gender, type of topical medication in use as well as frequency and duration of usage. A statistical analysis was performed.
RESULTS: A total of 75 patients answered the SPEED-Vp questionnaire. The mean age was 72 ± 7 years old. Fifty-two percent (n=39) were male, and 48% (n=36) were female patients. About 49.33% (n=37) had been on intraocular pressure (IOP)-lowering eyedrops for more than five years. About 61.43% (n=43) of patients used IOP-lowering eyedrops with preservatives. Most of the patients used prostaglandin analogs (75.71%, n=53) and beta-blockers (72.86%, n=51). SPEED score average was 2.75. About 25.33% (n=19) had no DED symptoms, 58.67% (n=44) had mild symptoms, 8% (n=6) had moderate symptoms and 8% (n=6) had severe symptoms. No statistically significant correlation was found between SPEED score and age, gender, number of eyedrop containers, number of active principles, application frequency, presence of preservatives, number of eyedrop containers with preservatives, duration of eyedrops usage or any of the medication groups.
CONCLUSIONS: Although a high percentage of patients were on eyedrops with preservatives, this low rate of symptoms might be because patients tended to devalue these symptoms; were already on treatment with artificial tears; or have an underestimation of the sensation of dry eye due to decreased neuronal corneal nerve responses and density. These results were surprisingly positive. This might also be the result of the healthcare provider\'s sensibilization to this issue (early diagnosis, early prescription of artificial tears and change from preservative to preservative-free medication).