title: Conjunctival goblet cells density and preservative-free tafluprost therapy for glaucoma: an in vivo confocal microscopy and impression cytology study.
abstract: OBJECTIVE
  To evaluate the density of conjunctival goblet cells (GCs) in glaucomatous patients treated with preservative-free (PF) tafluprost, using laser scanning confocal microscopy (LSCM) and impression cytology (IC).
  
  
  METHODS
  Thirty glaucomatous patients (30 eyes) naive for therapy and thirty healthy subjects (30 eyes) were enrolled. Conjunctiva was examined by means of Heidelberg Retina Tomography/Rostock cornea module. Afterwards, the specimens for IC were obtained. Patients were randomized to PF-tafluprost (Group 1) or preserved latanoprost (Group 2) and controls to the vehicle of latanoprost (Group 3) or physiological buffered saline solution (Group 4). Both LSCM and IC were performed at baseline, and after the 1st and 6th months of therapy, GC density (GCD) (cells/mm(2) ) was the main outcome measurement.
  
  
  RESULTS
  Baseline. Mean GCD was 240.69 ± 25.43 and 232.65 ± 23.52, for LSCM, and 162.10 ± 23.44 and 164.71 ± 21.03 for IC in Group 1 and 2, respectively. GC density values were not significantly different in Group 3 and 4 (p > 0.05%). Month one. Mean GCD increased to 284.16 ± 43.88 and 230.62 ± 48.32 in Group 1 (p < 0.001) and to 297.86 ± 26.87 and 221.78 ± 43.02 in Group 2 (p < 0.05), measured with LSCM and IC, respectively. In Group 3, GCD decreased to 205.88 ± 25.04 and 139.54 ± 17.37 measured with LSCM and IC, respectively (p < 0.05). Month six. Mean GCD did not change in Group 1 (p > 0.05) whereas it decreased in Group 2 (p < 0.05), compared to month 1. In Group 3, GCD further decreased to 166.32 ± 22.31 and 120.76 ± 11.66, measured with LSCM and IC, respectively (p < 0.05); in Group 4, mean GCD did not change during the study period (p > 0.05).
  
  
  CONCLUSIONS
  Treatment with PF tafluprost was associated with an increase in conjunctival GCD in glaucomatous eyes naïve for therapy. Further studies are mandatory to verify this finding because its validation may have important consequences in the medical management of glaucoma.
authors.affiliation: Department of Medicine and Ageing Science, Ophthalmic Clinic, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Mastropasqua
authors.forename: Luca
authors.initials: L
authors.lastname: Agnifili
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Fasanella
authors.forename: Claudia
authors.initials: C
authors.lastname: Curcio
authors.forename: Cristina
authors.initials: C
authors.lastname: Ciabattoni
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Mastropasqua
authors.forename: Lisa
authors.initials: L
authors.lastname: Toto
authors.forename: Marco
authors.initials: M
authors.lastname: Ciancaglini
mesh_terms: D002452:Cell Count; D003228:Conjunctiva / Q000473:pathology*; D003584:Cytological Techniques / Q000379:methods; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy / Q000473:pathology*; D020397:Goblet Cells / Q000473:pathology*; D006801:Humans; D018613:Microscopy, Confocal / Q000379:methods*; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D011310:Preservatives, Pharmaceutical; D011446:Prospective Studies; D011460:Prostaglandins F / Q000008:administration & dosage* / Q000627:therapeutic use; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D009883:Ophthalmic Solutions; D011310:Preservatives, Pharmaceutical; D011460:Prostaglandins F; C485333:tafluprost
keywords: conjunctival goblet cells; impression cytology and primary open angle glaucoma; in vivo confocal microscopy; preservative-free tafluprost