Clinical Dilemmas in Coexisting Ocular Surface Disease and Glaucoma.

IF 1.9 4区 医学 Q2 OPHTHALMOLOGY
Archana Singh, Ekta Arora, Sahib Y Tuteja, Dilpreet Singh
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引用次数: 0

Abstract

Background: Ocular surface disorders (OSD) and glaucoma often co exist. Intraocular pressure lowering medications and preservatives used with them may lead to ocular surface toxicity and drug induced cicatrizing conjunctivitis (DICC). Surgical management of glaucoma helps in reducing the requirement of topical anti glaucoma drugs but, at the same time, may also disrupt the ocular surface. On the other hand, medical therapies and surgeries required for management of OSD often lead to secondary glaucoma, thereby inducing a vicious cycle.

Methods: Relevant articles (English only) up to January, 2025 were searched from PubMed and summarized.

Results: Our review discusses the epidemiology, various diagnostic, therapeutic and surgical aspects of this interlinked scenario in a comprehensive manner. Medical therapies (steroids) utilized for controlling inflammation in OSD and related steroid induced glaucoma, anti glaucoma medications (and their preservatives) causing OSD and their respective available alternatives have been discussed in individual sections. Similarly, glaucoma surgeries causing OSD, surgeries for OSD leading to secondary glaucoma and the surgical considerations with possible alternatives, including the novel therapies, have been reviewed. The future directions, along with the role of gut microbiome in ocular diseases and the various therapeutic agents/interventions under clinical investigations, are also explored.

Conclusion: A deeper understanding of the interplay of different factors in these co-morbid conditions will help in breaking the vicious cycle induced and therefore, in offering more effective treatment. Recommendations for clinicians have been suggested to help optimize the treatment provided to this specific patient cohort of 'OSD and glaucoma'.

眼表疾病与青光眼共存的临床困境。
背景:眼表疾病(OSD)和青光眼经常共存。眼压降低药物和防腐剂可能导致眼表毒性和药物性结膜炎。青光眼的手术治疗有助于减少局部抗青光眼药物的需求,但同时也可能破坏眼表。另一方面,治疗OSD所需的药物治疗和手术往往导致继发性青光眼,从而形成恶性循环。方法:检索PubMed截至2025年1月的相关文献并进行汇总。结果:我们的综述讨论了流行病学,各种诊断,治疗和手术方面的综合方式这种相互关联的情况。用于控制OSD和相关类固醇性青光眼炎症的药物治疗(类固醇)、导致OSD的抗青光眼药物(及其防腐剂)及其各自可用的替代方案已在各个章节中进行了讨论。同样,对青光眼手术引起的OSD、OSD导致继发性青光眼的手术以及可能的替代手术考虑,包括新的治疗方法进行了综述。未来的发展方向,以及肠道微生物组在眼部疾病中的作用和临床研究中的各种治疗药物/干预措施。结论:深入了解这些合并症中不同因素的相互作用将有助于打破恶性循环,从而提供更有效的治疗。对临床医生的建议已被提出,以帮助优化提供给“OSD和青光眼”这一特定患者队列的治疗。
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来源期刊
Seminars in Ophthalmology
Seminars in Ophthalmology OPHTHALMOLOGY-
CiteScore
3.20
自引率
0.00%
发文量
80
审稿时长
>12 weeks
期刊介绍: Seminars in Ophthalmology offers current, clinically oriented reviews on the diagnosis and treatment of ophthalmic disorders. Each issue focuses on a single topic, with a primary emphasis on appropriate surgical techniques.
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