Ocular Surface, Intraocular Pressure and Lens Condition in Bronchodilator and Steroid-Treated Patients with Chronic Pulmonary Disease

OBJECTIVES

The aim of this study was to investigate ocular surface, intraocular pressure and lens condition in bronchodilator- and steroid-treated chronic pulmonary disease patients.

METHODS

In this cross-sectional clinical study, 101 patients with chronic pulmonary disease were treated with an inhaler and/or nebulized therapy for bronchodilatation. The patients were evaluated in 2 groups namely chronic obstructive pulmonary disease (COPD) and asthma. We investigated the effects of patient demographic characteristics, smoking, and medications on the presence of dry eye disease (DED), intraocular pressure, and cataract.

RESULTS

Patients had a mean age of 66.4 ± 11.9 years, and 46.5% (n = 47) were female. A unit increase in the length of inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) combination use was associated with a 1.02-fold increase in cataract risk (OR: 1.02, CI: 1.01-1.04, p = 0.016), and current smokers had 10.8 times as many cataracts (OR: 10.79, CI: 1.70-68.30, p = 0.011). Patients who used a nebulized corticosteroid had a 9.15 times higher risk of developing dry eyes than those who did not (OR: 9.15, CI: 2.34-35.75, p = 0.001). In patients using ICS-LABA, in comparison to formoterol beclomethasone, salmeterol fluticasone was found to increase the risk 7.49-fold for DED (OR: 7.49, CI: 1.48-35.75, p = 0.015).

CONCLUSIONS

Nebulizer delivery of steroids is associated with dry eye and cataracts. Smoking, ageing, and long-term inhaled steroid use have all been linked to an increased risk of cataracts. Longitudinal and larger sample size studies are needed to explore cause-effect relationships.

Ocular manifestations in hemodialysis patients and short-term changes in ophthalmologic findings

The purpose of this study was to investigate the frequency of ocular manifestations in hemodialysis (HD) patients and short-term changes in ophthalmologic findings. A total of 142 eyes of 71 HD patients were included in this study. Patients with corneal and conjunctival deposits, diabetic retinopathy, hypertensive retinopathy, cataract, optic atrophy, or glaucoma were recorded. Schirmer I tests and the tear break up time (TBUT) were performed in the listed order to evaluate dry eye. Axial length (AL) and anterior chamber depth (ACD) were measured using ultrasound biometry using an infrared system. The TBUT test, Schirmer I test, intraocular pressure, AL, and ACD were applied within 30 minutes before and after a single session of HD. The most common ocular findings included conjunctival calcification (60.6%), cataract (50.7%), and proliferative diabetic retinopathy (21.1%). The average TBUT results decreased from 10.81 ± 4.90 to 9.43 ± 4.78 seconds after HD, and was statistically significant (P < .001). The mean Schirmer I test results decreased from 13.59 ± 4.67 to 12.07 ± 4.86 mm after HD. The decline in the Schirmer I test results was statistically significant (P = .005). The mean intraocular pressure decreased from 14.57 ± 4.40 to 13.43 ± 3.91 mm Hg after HD, and was statistically significant (P < .001). The mean ACD increased from 3.19 ± 0.53 to 3.25 ± 0.55 mm, and the mean AL increased from 23.05 ± 1.35 to 23.13 ± 1.35 mm, both increases being significant after HD (both P < .001). Eye diseases such as diabetic retinopathy, corneo-conjunctival calcification, and dry eye are common in HD patients; these patients should undergo early and frequent eye examinations.

Aflibercept therapy in eyes with neovascular age-related macular degeneration and its effect on choroidal thickness

BACKGROUND

The purpose of this study was to investigate changes in best-corrected visual acuity (BCVA), central macular thickness (CMT) and subfoveal choroidal thickness (SCT) after intravitreal aflibercept injections for neovascular age-related macular degeneration (NV-AMD).

METHODS

Eighty-nine eyes (48 treatment naive, 41 resistant) were included in this prospective study. All patients were treated with three consecutive monthly injections then every two months as required. BCVA, CMT and SCT were recorded and compared within and between the two groups.

RESULTS

The mean increase in BCVA after injections was 0.18 ± 0.34 logMAR in the naive group (p = 0.01) and 0.092 ± 0.38 logMAR in the resistant group (p = 0.131). The mean decrease in CMT was 200.3 ± 216.1 μm in the naive group and 183.3 ± 203.4 μm in the resistant group (p < 0.001 for both). The mean decrease in SCT was 22.1 ± 62.0 μm in the naive group (p = 0.014). The mean change in SCT was 22.28 ± 74.05 μm in the resistant group; this was not statistically significant (p = 0.061).

CONCLUSION

BCVA, CMT and SCT decreased significantly after intravitreal aflibercept injections in naive patients with NV-AMD. Despite anatomic success, functional improvement was not reached and SCT did not significantly decrease after intravitreal aflibercept injections in resistant patients.