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Trans-conjunctival aqueous humor outflow in glaucomatous patients treated with prostaglandin analogues: an in vivo confocal microscopy study

  • Glaucoma
  • Published:
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Abstract

Purpose

To analyze, using in vivo laser scanning confocal microscopy (LSCM), the conjunctival features in glaucomatous patients receiving prostaglandin analogues (PGA).

Methods

Eighty eyes of 80 consecutive glaucomatous patients naive for therapy were enrolled; 30 eyes of 30 healthy subjects served as a control. Patients were randomized to: preservative-free (PF) and preserved latanoprost (groups 1 and 2, respectively), PF and preserved timolol (groups 3 and 4), and controls to vehicle of latanoprost or physiological buffered saline solution (groups 5 and 6). All subjects underwent LSCM of bulbar conjunctiva at baseline and 3 months after initiating therapy. The main outcomes were: mean density (MMD: cysts/mm2) and mean area (MMA: cysts/mm2) of epithelial microcysts. The relations between MMA and MMD with intraocular pressure (IOP), age, and mean defect (MD), were analyzed.

Results

At baseline, microcysts were found in all subjects. At month three, MMD did not change in all groups (p > 0.05). MMA significantly increased only in group 1 from 2,158.81 ± 524.09 to 3,877.77 ± 867.31, and in group 2 from 2,019.71 ± 541.03 to 5,560.39 ± 1,176.14, with values significantly higher in group 2 (p < 0.001). Significant relations were not found between MMD and MMA with IOP, MD, and age (p > 0.05).

Conclusions

PGA increased MMA in therapy-naive glaucomatous patients, indicating a possible enhancement of the trans-conjunctival aqueous humor outflow. Therefore, conjunctiva seems an additional target tissue to evaluate the hydrodynamic pathways in glaucoma and modifications induced by medical therapy.

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Conflict of interest

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None of the authors has a proprietary interest in the development or marketing of any of the products mentioned in this article. No funding or support has been received for the study. The results have not been previously presented at any conferences.

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Correspondence to Luca Agnifili.

Additional information

Rodolfo Mastropasqua and Vincenzo Fasanella contributed equally to this work and share primary authorship.

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Mastropasqua, R., Fasanella, V., Pedrotti, E. et al. Trans-conjunctival aqueous humor outflow in glaucomatous patients treated with prostaglandin analogues: an in vivo confocal microscopy study. Graefes Arch Clin Exp Ophthalmol 252, 1469–1476 (2014). https://doi.org/10.1007/s00417-014-2664-9

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  • DOI: https://doi.org/10.1007/s00417-014-2664-9

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