title: Incidence, severity and factors related to drug-induced keratoepitheliopathy with glaucoma medications.
abstract: OBJECTIVE
  To evaluate the incidence, severity, and factors related to drug-induced keratoepitheliopathy in eyes using antiglaucoma eye drops.
  
  
  METHODS
  In a cross-sectional study, 749 eyes from 427 patients who had used one or more antiglaucoma eye drops were examined at Niigata University Medical and Dental Hospital or related facilities. The incidence and severity of superficial punctate keratitis (SPK), patient gender and age, type of glaucoma, and type of eye drops were recorded. SPK was graded according to the AD (A, area; D, density) classification. The severity score (SS) was calculated from A x D.
  
  
  RESULTS
  SPK was observed in 382 (51.0%) of 749 eyes that had received any type of antiglaucoma eye drops. While 254 eyes (33.9%) were classified as A1D1 (SS 1), 34 eyes (4.6%) had severe SPK with SS 4 or more. The number of eye drops and the total dosing frequency per day were significantly greater in SPK-positive eyes than in eyes without SPK. The number of eye drops was proportional to the frequency and severity of SPK. Among eyes that were treated with three or more eye drops, SPK was more severe and more frequent in older patients (>/=71 years). In addition, a considerable difference was detected for each type of glaucoma.
  
  
  CONCLUSIONS
  Drug-induced keratoepitheliopathy is often observed in eyes that have received recent antiglaucoma eye drops. The number of eye drops, the total dose frequency per day, patient age, and type of glaucoma may affect this condition. We have to consider not only the effects on intraocular pressure but also the incidence and severity of drug-induced keratoepitheliopathy as a frequent side effect of glaucoma medications.
authors.affiliation: Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Fukuchi
authors.forename: Kimiko
authors.initials: K
authors.lastname: Wakai
authors.forename: Kieko
authors.initials: K
authors.lastname: Suda
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nakatsue
authors.forename: Hideko
authors.initials: H
authors.lastname: Sawada
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hara
authors.forename: Jun
authors.initials: J
authors.lastname: Ueda
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tanaka
authors.forename: Akiko
authors.initials: A
authors.lastname: Yamada
authors.forename: Haruki
authors.initials: H
authors.lastname: Abe
references.citation: Am J Ophthalmol. 1979 Oct;88(4):739-43
references.pmid: 507147
references.citation: Ophthalmic Res. 2000 Jan-Feb;32(1):3-8
references.pmid: 10657748
references.citation: Ophthalmology. 2006 Aug;113(8):1333-9
references.pmid: 16877072
references.citation: Arch Ophthalmol. 1998 Aug;116(8):1003-10
references.pmid: 9715679
references.citation: Ophthalmology. 1992 Jul;99(7):1082-8
references.pmid: 1495787
references.citation: Am J Ophthalmol. 1998 Sep;126(3):400-8
references.pmid: 9744373
references.citation: Surv Ophthalmol. 1980 Jul-Aug;25(1):15-30
references.pmid: 6998034
references.citation: J Glaucoma. 2003 Dec;12(6):486-90
references.pmid: 14646684
references.citation: J Glaucoma. 2008 Aug;17(5):350-5
references.pmid: 18703943
references.citation: Curr Eye Res. 2000 Feb;20(2):85-94
references.pmid: 10617908
references.citation: J Glaucoma. 2007 Jan;16(1):98-103
references.pmid: 17224758
references.citation: Ophthalmology. 1980 May;87(5):451-4
references.pmid: 7402591
references.citation: Ophthalmology. 1996 Jan;103(1):138-47
references.pmid: 8628544
references.citation: Br J Ophthalmol. 1994 May;78(5):377-80
references.pmid: 7912954
references.citation: Br J Ophthalmol. 1998 Jan;82(1):39-42
references.pmid: 9536878
references.citation: Invest Ophthalmol. 1976 Apr;15(4):246-59
references.pmid: 1262158
references.citation: Nippon Ganka Gakkai Zasshi. 2009 May;113(5):576-82
references.pmid: 19489448
references.citation: Arch Ophthalmol. 2003 Nov;121(11):1537-9
references.pmid: 14609908
references.citation: J Ocul Pharmacol Ther. 2003 Dec;19(6):517-25
references.pmid: 14733709
references.citation: Acta Ophthalmol Scand. 1999 Oct;77(5):541-3
references.pmid: 10551296
references.citation: Invest Ophthalmol Vis Sci. 1999 Mar;40(3):619-30
references.pmid: 10067965
references.citation: J Glaucoma. 2003 Dec;12(6):480-5
references.pmid: 14646683
references.citation: Cornea. 2006 Dec;25(10):1133-8
references.pmid: 17172885
references.citation: Ophthalmology. 1995 Dec;102(12):1743-52
references.pmid: 9098273
references.citation: Br J Ophthalmol. 1993 Sep;77(9):590-6
references.pmid: 8218059
references.citation: Ophthalmology. 1996 Jan;103(1):126-37
references.pmid: 8628543
references.citation: J Glaucoma. 2008 Apr-May;17(3):217-22
references.pmid: 18414108
references.citation: Br J Ophthalmol. 2002 Apr;86(4):418-23
references.pmid: 11914211
references.citation: Br J Ophthalmol. 1990 Jul;74(7):409-12
references.pmid: 2378856
references.citation: Invest Ophthalmol Vis Sci. 2005 Jul;46(7):2444-50
references.pmid: 15980234
references.citation: J Glaucoma. 1996 Feb;5(1):68-74
references.pmid: 8795737