title: Evaluation of Ocular Surface Disease in Asian Patients with Primary Angle Closure.
abstract: OBJECTIVE
  To evaluate the incidence of ocular surface disease (OSD) and to determine the effects of topical pressure-lowering drugs on ocular surface disease in primary angle closure patients.
  
  
  METHODS
  This was a cross-sectional comparative study comparing primary angle closure glaucoma (PACG) patients (Group A) with primary angle closure and primary angle closure suspect (Group B). Group A was treated with topical pressure-lowering drugs; Group B was not. Data on ocular diagnosis and details of treatment were obtained from medical records. Ocular surface disease incidence was assessed using the Ocular Surface Disease Index (OSDI) questionnaire and from clinical signs using Schirmer's test, tear break-up time and corneal fluorescein stain. Predictive Analytic Software 20 and STATA analysis software were used for statistical analyses.
  
  
  RESULTS
  Group A demonstrated a higher rate of OSD (OSDI 52.3%, Schirmer's test 70.5%, tear break-up time (TBUT) 75%, corneal staining 77.3%) compared to Group B (OSDI 39.0%, Schirmer's test 73.2%, TBUT 58.5% and cornea staining 14.6%) except for Schirmer's test. There was a significant difference in mean score of OSDI (p=0.004), TBUT (p=0.008) and cornea staining (p<0.001) between two groups. Primary angle closure glaucoma treated with more than two medications and for more than three years had worse ocular surface disease parameters but without statistical significant difference.
  
  
  CONCLUSIONS
  Ocular surface disease is common in PACG patients treated with topical pressure-lowering drugs. Topical pressure-lowering drugs caused significant OSD symptoms and signs except for tear production in PACG patients. Thorough evaluation of ocular surface disease is important to ensure appropriate treatment and intervention in PACG patients.
authors.affiliation: Department of Ophthalmology, School of Medical Sciences, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; Department of Ophthalmology, Hospital Selayang, Selangor, Malaysia.
authors.forename: Tan Ee
authors.initials: TE
authors.lastname: Ling
authors.affiliation: Department of Ophthalmology, School of Medical Sciences, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Khairuddin
authors.initials: K
authors.lastname: Othman
authors.affiliation: Department of Ophthalmology, Hospital Selayang, Selangor, Malaysia.
authors.forename: Ong Poh
authors.initials: OP
authors.lastname: Yan
authors.affiliation: Department of Ophthalmology, School of Medical Sciences, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Rasdi Abdul
authors.initials: RA
authors.lastname: Rashid
authors.affiliation: Department of Ophthalmology, School of Medical Sciences, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Cheong Min
authors.initials: CM
authors.lastname: Tet
authors.affiliation: Department of Ophthalmology, School of Medical Sciences, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Azhany
authors.initials: A
authors.lastname: Yaakob
authors.affiliation: Department of Ophthalmology, School of Medical Sciences, Health Campus Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Liza-Sharmini Ahmad
authors.initials: LA
authors.lastname: Tajudin
keywords: Cornea fluorescein staining; Ocular surface disease; Ocular surface disease index questionnaires; Primary angle closure glaucoma; Schirmer’s test; Tear break-up time