Intraocular light scatter in patients on topical intraocular pressure-lowering medication

Eur J Ophthalmol. 2018 Nov;28(6):652-661. doi: 10.1177/1120672117753667. Epub 2018 Apr 9.

Abstract

Purpose:: To quantify ocular light scattering in patients under treatment with intraocular pressure-lowering eye-drops.

Methods:: In this prospective, observational, cross-sectional case series study, 160 eyes of 160 patients with primary open angle glaucoma or primary ocular hypertension were consecutively recruited from our Glaucoma Department over 7 months. In total, 46 eyes of 46 healthy volunteers matched for age and sex served as the control group. The variables recorded in a single visit were as follows: drug and number of drops per day, treatment duration, OXFORD corneal staining grade, lower tear meniscus height as measured by spectral domain optical coherence tomography, ocular redness and non-invasive tear breakup time measured with the Oculus Keratograph 5M, ocular surface disease index questionnaire score and objective scatter index through a double-pass technique (Optical Analysis System II).

Results:: Objective scatter index was higher in the patient group (3.1, interquartile range = 1.8-5.47) than in the control group (1.95; interquartile range = 0.7-5; p = 0.017). In a multiple linear regression model, non-invasive tear breakup time was identified as the most influential variable on light scatter (mean ratio = -1.015; p = 0.003; 95% confidence interval = -1.025 to -1.005). No correlation with objective scatter index was observed for number of daily eye-drops, preservative concentration or treatment duration.

Conclusion:: Participants on anti-glaucoma medication showed a significantly higher objective scatter index than control group individuals. In the treated patient group, a lower non-invasive tear breakup time was associated with a higher objective scatter index. This suggests that lubricating eye-drops to improve tear breakup time could also improve vision quality in these patients by diminishing light scattering.

Keywords: Ocular light scattering; glaucoma; intraocular pressure–lowering medication; ocular surface disease.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Case-Control Studies
  • Cornea / pathology
  • Cross-Sectional Studies
  • Female
  • Glaucoma, Open-Angle / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Ocular Hypertension / drug therapy*
  • Preservatives, Pharmaceutical / adverse effects
  • Prospective Studies
  • Refraction, Ocular / physiology
  • Regression Analysis
  • Scattering, Radiation*
  • Surveys and Questionnaires
  • Tears / chemistry
  • Tonometry, Ocular
  • Vision, Ocular / physiology*

Substances

  • Antihypertensive Agents
  • Preservatives, Pharmaceutical