Meibomian Gland Changes in Open-angle Glaucoma Users Treated with Topical Medication

Area of Science:

• Ophthalmology
• Ocular Surface Disease
• Glaucoma Management

Background:

• Topical hypotensive eye drops are standard for glaucoma management.
• These treatments can induce ocular surface changes, affecting lid margin and meibomian glands.
• Meibomian gland dysfunction (MGD) is a common cause of dry eye disease.

Purpose of the Study:

• To evaluate meibomian gland dysfunction in glaucoma patients undergoing topical antiglaucomatous treatment.
• To assess the impact of preservatives in topical treatments on ocular surface parameters.

Main Methods:

• Prospective study of 131 glaucoma patients on topical medication and 92 controls with untreated ocular hypertension.
• Meibomian gland structure assessed via noncontact meibography; function evaluated by expressibility, duct appearance, and Marx line location.
• Tear osmolarity, corneal staining (Oxford scale), and ocular symptoms (OSDI) were measured; comparison between preservative and preservative-free treatments.

Main Results:

• Glaucoma patients showed significantly higher meibomian gland depletion, altered gland quantity, and reduced meibum expressibility compared to controls (P < .001).
• Increased corneal staining (Oxford scale) was observed in the glaucoma group (P < .001).
• Preservative-containing treatments correlated with higher Marx line scores (P < .001 central, P < .003 temporal); MGD-predictive factors identified.

Conclusions:

• Topical glaucoma treatments induce meibomian gland dysfunction, affecting gland structure and function.
• The presence of preservatives in topical treatments exacerbates MGD and associated ocular surface changes.
• Identifying MGD is crucial in glaucoma patients using topical medications, especially those with preservatives.