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Abysheva L. D.1, Avdeev R. V.2, Alexandrov A. S.3, Arapiev M. U.4, Bakunina N. A.5, Baranova N. A.3, Basinskiy A. S.6, Brezhnev A. Yu.7, Gazizova I. R.8, Galimova A. B.9, Gapon’ko O. V.3, 10, Gar’kavenko V. V.11, Getmanova A. M.12, Gorodnichiy V. V.3, Gusarevitch A. A.13, Dorofeev D. A.14, Zhavoronkov S. A.15, Zavadskiy P. Ch.16, Zakharova M. A.3, Zakhidov A. B.17, Zvereva O. G.18, 19, Isakov I. N.20, Karimov U. R.21, Kondrakova I. V.3, Kuroyedov A. V.3, 10, Lanin S. N.22, Lovpache Dzh. N.4, Loskutov I. A.23, Molchanova E. V.24, Nagornova Z. M.25, Onufriychuk O. N.26, Petrov S. Yu.27, Rozhko Yu. I.28, Seleznev A. V.25, Tashtitova L. B.1, Khohlova A. S.29, Shaposhnikova I. V.30, Shahalova A. P.31


1Kazakh Scientific Research Institute of Eye Diseases, Almaty, Kazakhstan; 2State Medical Academy named after N. N. Burdenko, Voronezh, Russia; 3Central Military Clinical Hospital named after P. V. Mandryka, Moscow, Russia; 4Moscow Scientifc Research Institute of Eye Diseases named after Helmholtz, Moscow, Russia; 5City Clinical Hospital No 1 named after N. I. Pirogov, Moscow, Russia; 6Ophthalmological Center of S. N. Basynskiy, Ltd., Orel, Russia; 7State Medical University, Kursk, Russia; 8North-West Federal Medical and Research Center, Saint-Petersburg, Russia; 9All-Russian Eye and Plastic Surgery Center, Ufa, Russia; 10Russian National Research Medical University named after N. I. Pirogov, Moscow, Russia; 11State Medical University named after V. F. Voyno-Yasenetskiy, Krasnoyarsk, Russia; 12Regional Hospital No 1, Bryansk, Russia; 13Regional Railway Clinical Hospital, Novosibirsk, Russia; 14Regional Ophthalmological Clinical Hospital No 3, Chelyabinsk, Russia; 15City Hospital No 15 named after O. M. Filatov, Moscow, Russia; 16Medical Center “New Vision” Minsk, Belarus; 17Ophthalmosurgery Medical Center “SAIF-OPTIMA”, Tashkent, Uzbekistan; 18Regional Clinical Ophthalmological Hospital, Kazan, Russia; 19State Medical Academy, Kazan, Russia; 20Diagnostic and Treatment Center of “NZRMK named after N. E. Kryukov”, Novokuznetsk, Russia; 21Regional Ophthalmological Hospital, Gulistan, Uzbekistan; 22Ophthalmological Clinical Hospital named after P. G. Makarov, Krasnoyarsk, Russia; 23Russian Railway Clinical and Research Medical Center, Moscow, Russia; 24State Medical Academy, Omsk, Russia; 25State Medical Academy, Ivanovo, Russia; 26Ophthalmic Diagnostic City Center No 7, Saint-Petersburg, Russia; 27Scientific and Research State Ophthalmological Institute, Moscow, Russia; 28State Hospital, Gomel, Belarus; 29Pacific State Medical University, Vladivostok, Russia; 30Medical Clinical Center “Good Visionˮ, Kemerovo, Russia; 31Medical Clinical Center “Tonus Amarisˮ, Nizhny Novgorod, Russia

Abstract

Aim. To determine the characteristics of dry eye syndrome (DES) onset and progression in patients with primary open-angle glaucoma (POAG), depending on the disease stage, treatment regimens and patient age. 

 Patients and methods. The final protocol of combined analytical multicenter cohort study conducted from January to May 2016 included data of 530 persons (866 eyes): 398 patients with POAG and 132 patients without signs of glaucoma. Ophthalmic examination with the aim to verify glaucoma diagnosis included tonometry, morphometric analysis (optical coherence tomography), functional visual field loss analysis (Humphrey perimetry). DES diagnostic tests included tear film break-up time test (TBUT), Schirmer’s test, lissamine green staining and ocular surface disease index (OSDI) test.

 Results. Prevalence of DES among glaucoma patients aged 51–60, 61–70 and 71–80 years was 9.5, 27.8 and 5.2 % respectively higher, than in control groups of the same age. The stability of the preterminal tear film in all age categories in patients with glaucoma was statistically significantly less than in the comparison group (p < 0.05). The results of the Schirmer test were lower in glaucoma patients compared with the control group as a whole, with statistically significant differences in age subgroups of 41–50 years and 61–70 years (p < 0.05). Frequency and severity of conjunctival and corneal epithelium damage, detected by lissamine green staining, were more expressed in medically treated glaucoma eyes (p < 0.05). No correlation was found between the severity of the DES clinical features and glaucoma stage according to the results of the “classicˮ tests (Schirmer and TBUT). The severity of objective DES symptoms depends on the medical treatment regimen. Significantly lower tear production and tear film stability were associated with the most intensive treatment regimens (combination treatment using 2 and more components) characterized by maximum amount of instillations per day. The intensity of complaints at the stage of the final examination is directly proportional to the duration of drug therapy of glaucoma.

 Conclusion. Ophthalmologists have to take into account the possible onset and progression of DES when they plan glaucoma medical treatment strategy. This will minimize the degree of discomfort, improve quality of life and compliance of these patients and, ultimately, provide better and more effective treatment of glaucoma.

Keywords: glaucoma, dry eye syndrome, ocular surface disease, treatment regimen. 


REFERENCES

  1. Varma R, Lee PP, Goldberg I, Kotak S. An assessment of the health and economic burdens of glaucoma. Am. J. Ophthalmol. 2011;152(4):515–522.
  2. Robin AL, Novack GD, Covert DW, et al. Adherence in glaucoma: objective measurements of once-daily and adjunctive medication use. Am. J. Ophthalmol. 2007;144(4):533–540.
  3. Golubev SYu, Kuroyedov AV. [Choice of cost-effective medicine for the prevention and treatment of dry eye syndrome]. «Dry Eye» syndrome. 2002;3:12–14. (in Russian).
  4. The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the International Dry Eye WorkShop (2007). The ocular surface. 2007;5(2):93–107.
  5. Brzheskij VV, Radukhan M. [Glaucoma and the «dry eye» syndrome]. Ophthalmology J. 2014;7(2):37–49. (in Russian).
  6. Brezhnev AYu, Baranov VI, Petrov SYu. [Pseudoexfoliation syndrome as a risk factor for «dry eye» syndrome]. RMJ. Clinical ophthalmology. 2016;17(1):30–34. (in Russian).
  7. Brzheskiy VV, Egorova GB, Egorov EA. [«Dry eye» syndrome and diseases of the eye surface: clinical course, diagnostics, treatment]. Moscow: GEOTAR-Media; 2016. 464 p. (in Russian).
  8. Brzheskij VV, Somov EE. [Corneal and conjunctival xerosis]. Saint-Petersburg; 2003. 119 p. (in Russian).
  9. Egorov EA, Brzheskij VV, Muratova NV. [Undesirable effects of ophthalmo-hypotensive therapy: «dry eye» syndrome]. Glaucoma News. 2009;3:3–5. (in Russian).
  10. Egorov EA. [Glaucoma. National Guideline]. Moscow: GEOTAR-Media; 2013. 824 p. (in Russian).
  11. Egorov EA, Astahov JuS, Erichev VP. [Glaucoma. National Guideline]. Moscow: GEOTARMedia; 2015. 456 p. (in Russian).
  12. Egorov EA, Kuroyedov AV. [Clinical and epidemiological characteristics of glaucoma in CIS and Georgia. Results of multicenter opened retrospective trial (part 1)]. Clin. Ophthalmol. 2011;3:97–100. (in Russian).
  13. Egorov EA, Kuroyedov AV. [Clinical and epidemiological characteristics of glaucoma in CIS and Georgia. Results of multicenter opened retrospective trial (part 2)]. Clin. Ophthalmol. 2012;1:19–22. (in Russian).
  14. Avdeev RV, Alexandrov AS, Basinskiy AS, et al. [Risk factors of glaucoma development and progression according to the results of a multicenter study of Russian glaucoma society]. Medical and biological problems. 2012;2(8):57–69. (in Russian).
  15. Avdeev RV, Alexandrov AS, Basinskiy AS, et al. [The degree of mutual influence and the relationship between morphofunctional characteristics of primary open angle glaucoma and macular degeneration]. Ophthalmology J. 2014;7(1):19–27. (in Russian).
  16. Avdeev RV, Alexandrov AS, Bakynina NA, et al. [Prediction of the disease duration and the age of patients with different stages of primary open-angle glaucoma]. National J. Glaucoma. 2014;13(2):60–69. (in Russian).
  17. Abysheva LD, Avdeev RV, Alexandrov AS, et al. [Multicenter study of IOP level in patients with moderate and advanced primary open-angle glaucoma during the treatment]. Ophthalmology J. 2015;8(1):43–60. (in Russian).
  18. Kuroedov AV, Abysheva LD, Avdeev RV, et al. [The cost-effectiveness ratio study during local hypotensive therapy in patients with advanced primary open angle glaucoma (multicenter study)]. Russian Ophthalmological J. 2015;8(3):10–22. (in Russian).
  19. Abysheva LD, Avdeev RV, Aleksandrov AS, et al. [Optimum upper level of IOP in patients with advanced primary open angle glaucoma in terms of evidence-based medicine]. RMJ. Clinical Ophthalmology. 2015;8(3):111–123. (in Russian).
  20. Kuroedov AV, Avdeev RV, Aleksandrov AS, et al. [Primary open-angle glaucoma: at what age of the patient and at what duration of the disease blindness can occur]. Medical and biological problems of life. 2014;2(12):74–84. (in Russian).
  21. Avdeev RV, Aleksandrov AS, Bakunina NA, et al. [Model of primary open angle glaucoma manifestations and outcomes]. Clinical medicine. 2014;92(12):64–72. (in Russian).
  22. Avdeev RV, Aleksandrov AS, Basinskii AS, et al. [Multicentre study of morphofunctional status of visual analyzer in simultaneous presence of glaucoma and age-related macular degeneration in one eye with determination of their correlations and connections]. Ophthalmology. Eastern Europe. 2013;4:15–25. (in Russian).
  23. Abysheva LD, Aleksandrov AS, Arapiev MU. [Optimization of diagnosis and treatment options in primary open-angle glaucoma patients]. National J. Glaucoma. 2016;15(2):19–35. (in Russian).

Received: 29 June 2017

Published: December 2017