Tear film osmolarity in patients treated for glaucoma or ocular hypertension.
OBJECTIVE
To evaluate tear film osmolarity in patients treated with intraocular pressure-lowering medications.


METHODS
Forty patients treated for glaucoma or ocular hypertension (OHT) were consecutively recruited for the study. Each patient was asked to complete an evaluation of ocular surface disease symptoms, the Ocular Surface Disease Index, and underwent a complete evaluation of the ocular surface including measurement of tear film osmolarity, Schirmer test, tear breakup time (TBUT), and corneal and conjunctival staining.


RESULTS
Twenty-four patients (60%) reported ocular surface disease symptoms. Nineteen patients (47.5%) had a tear osmolarity ≤308 mOsms/L, 11 (27.5%) between 309 and 328 mOsms/L, and 10 (25%) >328 mOsms/L. A tear deficiency was observed in 20 patients (50%). Twenty-seven patients (67.5%) had an abnormal tear quality analyzed with TBUT, and 16 patients (40%) showed positive staining using the Oxford schema. Tear osmolarity was significantly correlated to Ocular Surface Disease Index (r = 0.486; P = 0.002) and TBUT (r = -0.49; P = 0.009). There was a statistically significant correlation between tear osmolarity and the number of drugs (r = 0.409; P = 0.009), the number of instillations (r = 0.405; P = 0.01), and the number of instillations of preserved eye drops (r = 0.629; P < 0.0001). Using the multiple regression method, tear osmolarity remained significantly correlated to the number of instillations of preserved eye drops (P = 0.004).


CONCLUSIONS
Tear osmolarity was increased in patients treated for glaucoma or OHT, particularly in those using multiple preserved eye drops. The evaluation of the ocular surface of patients treated for glaucoma or OHT may benefit from such analysis, and future trials for new intraocular pressure-lowering eye drops should thus evaluate tear osmolarity.
Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France. alabbe@quinze-vingts.fr
Antoine
A
Labbé
Ophélie
O
Terry
Emmanuelle
E
Brasnu
Charles
C
Van Went
Christophe
C
Baudouin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects; D002908:Chronic Disease; D003228:Conjunctiva / Q000187:drug effects; D003315:Cornea / Q000187:drug effects; D015352:Dry Eye Syndromes / Q000139:chemically induced; D005260:Female; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy; D009994:Osmolar Concentration; D011310:Preservatives, Pharmaceutical / Q000008:administration & dosage / Q000009:adverse effects; D013666:Tears / Q000737:chemistry*
D000959:Antihypertensive Agents; D011310:Preservatives, Pharmaceutical