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Purpose To examine the relationship between ocular surface disease (OSD) and topical antiglaucoma therapy. Methods A total of 211 eyes of 211 patients with open-angle glaucoma or ocular hypertension on topical medication were recruited over 10 months. Controls were 51 eyes of 51 healthy age- and sex-matched volunteers. In each patient, we recorded the intraocular pressure-lowering eyedrops used, the number of medications used, and daily and cumulative preservative concentrations (PC). Main outcome measures were fluorescein corneal staining score (Oxford scale), lower tear meniscus height (LTMH) (spectral-domain optical coherence tomography), noninvasive tear film breakup time (NI-TBUT) (Oculus Keratograph 5M), and OSD symptom questionnaire index (OSDI). Results Compared to controls, significantly higher OSDI (median [interquartile range] 10.24 [4.54-18.94] vs 2.5 [0-12.5]; p0.05). A higher daily PC was associated with a lower LTMH (R −0.142; p = 0.043). In the medication group, multivariate analysis identified correlations between benzalkonium chloride (BAK) (odds ratio [OR] 1.56) and BAK plus polyquaternium-containing drops (OR 5.09) or higher OSDI (OR 1.06) and abnormal corneal staining test results and between older age (mean ratio [MR] 1.05), longer treatment duration (MR 1.02), or corneal staining presence (MR 1.22) and a higher OSDI score. Conclusions Ocular surface disease was more prevalent in the medication group. The main factors impacting OSD were drops with preservatives, longer treatment duration, and older age.

Purpose: To quantify ocular light scattering in patients under treatment with intraocular pressure–lowering eye-drops. Methods: In this prospective, observational, cross-sectional case series study, 160 eyes of 160 patients with primary open angle glaucoma or primary ocular hypertension were consecutively recruited from our Glaucoma Department over 7 months. In total, 46 eyes of 46 healthy volunteers matched for age and sex served as the control group. The variables recorded in a single visit were as follows: drug and number of drops per day, treatment duration, OXFORD corneal staining grade, lower tear meniscus height as measured by spectral domain optical coherence tomography, ocular redness and non-invasive tear breakup time measured with the Oculus Keratograph 5M, ocular surface disease index questionnaire score and objective scatter index through a double-pass technique (Optical Analysis System II). Results: Objective scatter index was higher in the patient group (3.1, interquartile range = 1.8–5.47) than in the control group (1.95; interquartile range = 0.7–5; p = 0.017). In a multiple linear regression model, non-invasive tear breakup time was identified as the most influential variable on light scatter (mean ratio = −1.015; p = 0.003; 95% confidence interval = −1.025 to −1.005). No correlation with objective scatter index was observed for number of daily eye-drops, preservative concentration or treatment duration. Conclusion: Participants on anti-glaucoma medication showed a significantly higher objective scatter index than control group individuals. In the treated patient group, a lower non-invasive tear breakup time was associated with a higher objective scatter index. This suggests that lubricating eye-drops to improve tear breakup time could also improve vision quality in these patients by diminishing light scattering.

Purpose To describe the incidence of retinal angiomatous proliferation (RAP) reactivation after combined treatment with a high-dose intravitreal triamcinolone acetonide (IVTA) and photodynamic therapy (PDT) at 1-year follow-up. Methods All patients had undergone a full ophthalmic examination. High-dose IVTA (20 mg) was injected via pars plana. Four to 7 days later, PDT was delivered. Results Fourteen eyes of 13 patients were included. Eight lesions (57%) reopened and needed retreatment with combined therapy at 6 months follow-up. At 1-year follow up, the lesion was obliterated in nine cases (64.2%) and best-corrected visual acuity improved from 0.87 logMar (range, 0.7–1) to 0.79 logMar (range, 0.5–1). Conclusions Combined therapy using high-dose IVTA and PDT is beneficial in stabilizing RAP. However, a high incidence of RAP reactivation has been observed at 6 months, even with a high-dose IVTA injection.

Purpose To determine the possible influence of pupil dilation on intraocular lens (IOL) power predictions made using optical biometry with Lenstar LS 900® (Haag-Streit AG, Koeniz, Switzerland). Methods A total of 72 eyes of 72 patients scheduled to undergo cataract surgery were prospectively examined using the optical low-coherence reflectometry (OLCR) optical biometer before and after pupil dilation with tropicamide 1%. The measurements made were axial length, central corneal thickness, anterior chamber depth (ACD), lens thickness, mean keratometry, corneal diameter (CD), and pupil diameter. Holladay II and SRK/T formulas were used to calculate IOL power. Agreement between the 2 measurement modes (with and without dilation) was assessed by calculating intraclass correlation coefficients (ICC) and constructing Bland-Altman plots. Results The mean age of the patients was 74.71 ± 7.53 years (range 56–90). Among the variables determined, only ACD varied significantly according to pupil dilation (pConclusions The use of pupil dilation does not seem to influence measurements and IOL predictions made using this OLCR optical biometer.

Purpose. To evaluate the influence of retinal angiomatous proliferation (RAP) stage on visual and anatomic outcome after ranibizumab (Lucentis®). Methods. This was a prospective study on consecutively diagnosed RAP eyes at the Hospital Clínico San Carlos, Madrid. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) are performed monthly. Indocyanine green angiography (ICG) and fluorescein angiography (FA) are performed at baseline and every 3 months thereafter. A starting dose of a monthly ranibizumab injection in the first 3 months is followed by retreatment in case of intraretinal edema, subretinal fluid, or pigment epithelium detachment (PED) in OCT, increased leakage in FA, or a hot spot in ICG. Results. A total of 53 eyes from 49 patients were included. The mean change in BCVA at 12 months was +7.3, +0.83, and −2.1 letters in stages IIA (21 cases), Il B (18 cases), and III (14 cases), respectively. After adjusting the change in BCVA according to baseline BCVA, β coefficient was −6.012 letters (p=0.025) in stage IIB and −9.762 letters (p=0.003) in stage III vs stage IIA. Four cases had a retinal pigment epithelium tear after injection of ranibizumab. Conclusions. Patients in stage II without PED have a better visual and anatomic evolution than patients in stage II with PED and stage III.