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Structural and Molecular Tear Film Changes in Glaucoma.
Rodolfo Mastropasqua1, Luca Agnifili2, Leonardo Mastropasqua2
1Whipps Cross University Hospital, Eye Treatment Center, London, United Kingdom.
Current Medicinal Chemistry
|October 12, 2018
Summary
Glaucoma treatments disrupt the tear film (TF), causing dry eye symptoms and altering ocular surface homeostasis. These tear film changes may serve as potential biomarkers for glaucoma management.
Area of Science:
- Ophthalmology and Vision Science
- Ocular Surface Disease
- Pharmacological Impact on Ocular Health
Background:
- The tear film (TF) is crucial for ocular surface (OS) integrity and vision quality.
- Glaucoma medical therapy significantly disrupts OS homeostasis, affecting all ocular surface components.
- Preservatives, instillation frequency, and therapy duration are key contributors to TF alterations.
Purpose of the Study:
- To review tear film changes associated with glaucoma.
- To explore the link between TF alterations, glaucoma-related ocular surface disease, and patient quality of life.
- To assess the utility of TF molecular variations as potential glaucoma biomarkers.
Main Methods:
- Review of existing literature on tear film changes in glaucoma patients undergoing medical therapy.
- Analysis of physio-pathological mechanisms causing TF alterations (toxic, allergic, cellular loss).
- Investigation of molecular modifications in the tear film reflecting ocular surface inflammation.
Main Results:
- Glaucoma therapy induces TF changes: mucus thinning, reduced mucin, decreased aqueous volume, and lipid layer thinning, leading to increased tear evaporation.
- Hyperosmolarity and TF instability are hallmarks of iatrogenic dry eye caused by glaucoma treatment.
- Molecular modifications in TF indicate an inflammatory status, potentially linked to disease or therapy.
Conclusions:
- Glaucoma medical therapy profoundly impacts tear film structure and function, contributing to ocular surface disease.
- Tear film alterations are directly linked to patient quality of life and represent a form of iatrogenic dry eye.
- Molecular changes in the tear film show promise as candidate biomarkers for glaucoma diagnosis and monitoring.
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