title: Effects of long-term topical anti-glaucoma medications on meibomian glands.
abstract: OBJECTIVE
  To examine effects of long-term topical anti-glaucoma medications on meibomian gland morphology and function and assess their relationship with slit-lamp findings.
  
  
  METHODS
  This was a cross-sectional observational case series of 31 patients with glaucoma (mean age ± standard deviation, 65.0 ± 13.0 years; mean duration of eye drop use, 7.9 ± 6.0 years) treated with topical anti-glaucoma drugs in only one eye for more than 1 year: 13 receiving prostaglandin analogues (PGs) alone, eight receiving β-blockers alone, and ten receiving multiple treatments. Untreated contralateral eyes served as controls. Lid margin (lid margin abnormality score: 0-4) and superficial punctate keratopathy (SPK score: 0-1) were observed with a slit lamp. Upper and lower eyelids were turned over to observe meibomian glands using non-contact meibography. Meibomian gland loss was scored for each eyelid from grade 0 (no loss of meibomian glands) through grade 3 (loss >2/3 of total meibomian gland area). Meibomian lipid content (meibum) was scored (meibum score: 0-3).
  
  
  RESULTS
  Treated eyes had significantly higher scores for lid margin abnormality (P= 0.001), SPK (P< 0.001), meibo-score (P< 0.001), and meibum (P< 0.001) than control eyes. Tear film break-up time (BUT) was significantly shorter in treated eyes than in control eyes (P= 0.001). Schirmer values were significantly lower in treated eyes than in control eyes (P= 0.0039). Subgroup analysis indicated a significantly higher meibo-score in eyes treated with PGs (P= 0.0046) and in eyes treated with β-blockers (P= 0.0231) than in the corresponding controls.
  
  
  CONCLUSIONS
  Long-term anti-glaucoma eye drop use affects meibomian gland morphology and function.
authors.affiliation: Itoh Clinic, 626-11 Minaminakano, Minuma-ku, Saitama City, Saitama, 337-0042, Japan. ritoh@za2.so-net.ne.jp
authors.forename: Reiko
authors.initials: R
authors.lastname: Arita
authors.forename: Kouzo
authors.initials: K
authors.lastname: Itoh
authors.forename: Shuji
authors.initials: S
authors.lastname: Maeda
authors.forename: Koshi
authors.initials: K
authors.lastname: Maeda
authors.forename: Ayumu
authors.initials: A
authors.lastname: Furuta
authors.forename: Atsuo
authors.initials: A
authors.lastname: Tomidokoro
authors.forename: Makoto
authors.initials: M
authors.lastname: Aihara
authors.forename: Shiro
authors.initials: S
authors.lastname: Amano
mesh_terms: D000287:Administration, Topical; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005141:Eyelid Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D000077338:Latanoprost; D008297:Male; D008537:Meibomian Glands / Q000187:drug effects* / Q000473:pathology; D008875:Middle Aged; D011461:Prostaglandins F, Synthetic / Q000008:administration & dosage / Q000009:adverse effects*; D011859:Radiography
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D011461:Prostaglandins F, Synthetic; D000077338:Latanoprost