title: Ocular surface changes induced by topical antiglaucoma monotherapy.
abstract: OBJECTIVE
  To investigate the expression of inflammatory markers HLA-DR in impression cytology specimens from patients receiving topical antiglaucoma monotherapy.
  
  
  METHODS
  Impression cytology specimens were obtained from patients taking no topical medication (n = 13) and from primary open-angle glaucoma or ocular hypertensive patients taking one topical medication for at least 3 months (latanoprost n = 14; betaxolol n = 12; timolol n = 14). None of the patients had any signs of ocular surface inflammation as detected by slit-lamp examination, a normal Schirmer's test and tear breakup time. The expression of HLA-DR on epithelial cells and T lymphocytes was analysed by flow cytometry.
  
  
  RESULTS
  A significant increase in HLA-DR on epithelial cells in patients on monotherapy was detected (latanoprost p < 0.05; betaxolol p < 0.01; timolol p < 0.01). Although the duration of treatment differed significantly between individual groups, there was no significant correlation between the length of monotherapy and the expression of inflammatory markers by epithelial cells and T lymphocytes. In the latanoprost group, the increased expression of HLA-DR was associated with a shorter duration of treatment.
  
  
  CONCLUSIONS
  The flow-cytometric results indicate that administration of a single topical medication preserved with benzalkonium chloride, irrespective of type, for 3 months or more induced a significant degree of subclinical inflammation detected as increased expression of HLA-DR on conjunctival epithelial cells.
authors.affiliation: Eye Clinic, Medical Center Ljubljana, Medical Faculty, Slovenia. barbara.cvenkel@kclj.si
authors.forename: Barbara
authors.initials: B
authors.lastname: Cvenkel
authors.forename: Alojz
authors.initials: A
authors.lastname: Ihan
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015784:Betaxolol / Q000009:adverse effects / Q000627:therapeutic use; D003228:Conjunctiva / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D003231:Conjunctivitis / Q000139:chemically induced* / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D000077338:Latanoprost; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy; D009883:Ophthalmic Solutions; D011461:Prostaglandins F, Synthetic / Q000009:adverse effects / Q000627:therapeutic use; D013601:T-Lymphocytes / Q000276:immunology; D013999:Timolol / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D006684:HLA-DR Antigens; D009883:Ophthalmic Solutions; D011461:Prostaglandins F, Synthetic; D000077338:Latanoprost; D013999:Timolol; D015784:Betaxolol