DOI: https://doi.org/10.22263/2312-4156.2025.5.67
H.I. Yakubenka1, I.I. Generalov1, T.K. Savunova2
Diagnostic possibilities of drug-induced «dry eye» disease in patients with glaucoma
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2The Institute for Advanced Training & Retraining of Healthcare Personnel of the Educational Institution “Belarusian State Medical University”, Minsk, Republic of Belarus
Vestnik VGMU. 2025;24(5):67-77.
Abstract.
Objectives. To evaluate the condition of the ocular surface, the frequency of “dry eye” disease (DED) and to determine the amount of extracellular DNA in the lacrimal fluid in patients with primary open-angle glaucoma depending on the duration of hypotensive therapy.
Material and methods. The study involved 97 people (128 eyes) including 70 women (72%) and 27 men (28%) whose average age was 66,3 [63; 70] years. Three groups of participants were formed. Group I included 37 people (59 eyes) with newly diagnosed primary open-angle glaucoma I a-b (POAG), who had not previously received local hypotensive therapy. Group II included 20 people (29 eyes) diagnosed with primary open-angle glaucoma I-II a (POAG),who, for a year, had been instilled a preserved form of an antihypertensive drug from the group of prostaglandin analogues (AG).The III-d control group consisted of 40 people (40 eyes) without diagnosis of primary open-angle glaucoma. In addition to the standard ophthalmological examination, the tear production, tear film, the condition of eyelid margins and the meibomian glands as well as the ocular surface vital dye staining were assessed. To determine extracellular DNA, 82 samples of tear fluid were collected using filter strips.
Results. DED was diagnosed in 74,6% of cases in patients with POAG before starting hypotensive eye drops; a mild degree of DED prevailed and was recorded in 77,2% of patients, a moderate one in 22,8%. Xerosis of the ocular surface with a tendency to worsening the condition was detected in all patients who had been receiving topical hypotensive therapy for a year: a mild degree was observed in 27,6% of patients, a moderate one in 72,4%, p<0,001. The amount of extracellular DNA in the lacrimal fluid statistically significantly differed between the groups studied. A higher level of extracellular DNA was found in second group.
Conclusions. After a year of topical therapy with AG containing a preservative, changes in functioning of the meibomian glands, the disruption of tear film stability, the degeneration of ocular surface epithelium and an increased amount of extracellular DNA in the lacrimal fluid were detected. Patients with glaucoma require a thorough assessment of the ocular surface condition both before starting hypotensive therapy and during treatment.
Keywords: tear film, ocular surface, dry eye disease, primary open angle glaucoma, antiglaucoma therapy, extracellular DNA.
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Submitted 12.08.2025
Accepted 21.10.2025
Information about authors:
Hanna I. Yakubenka – Senior Lecturer of the Chair of Ophthalmology and Otolaryngology, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-9362-9590, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.;
I.I. Generalov – Doctor of Medical Sciences, professor of the Chair of Clinical Microbiology, Vitebsk State Order of Peoples’ Friendship Medical University;
T. K. Savunova – Candidate of Medical Sciences, associate professor of the Chair of Ophthalmology, The Institute for Advanced Training & Retraining of Healthcare Personnel of the Educational Institution “Belarusian State Medical University”.
