Interleukin-1β tear concentration in glaucomatous and ocular hypertensive patients treated with preservative-free nonselective beta-blockers

Manni, Gianluca; Centofanti, Marco; Oddone, Francesco; Parravano, Mariacristina; Bucci, Massimo G.

doi:10.1016/j.ajo.2004.08.028

« Previous Next »American Journal of Ophthalmology
Volume 139, Issue 1 , Pages 72-77, January 2005

Interleukin-1β tear concentration in glaucomatous and ocular hypertensive patients treated with preservative-free nonselective beta-blockers

Gianluca Manni, MD
- University of Rome “Tor Vergata”, Dipartimento di Biopatologie e Diagnostica per Immagini; Fondazione G.B. Bietti for the Study and Research in Ophthalmology, Rome, Italy.
Marco Centofanti, MD, PhD
- University of Rome “Tor Vergata”, Dipartimento di Biopatologie e Diagnostica per Immagini; Fondazione G.B. Bietti for the Study and Research in Ophthalmology, Rome, Italy.
Francesco Oddone, MD
- University of Rome “Tor Vergata”, Dipartimento di Biopatologie e Diagnostica per Immagini; Fondazione G.B. Bietti for the Study and Research in Ophthalmology, Rome, Italy.
- Inquiries to Francesco Oddone, MD, Fondazione G.B. Bietti, Viale Oxford 81, Rome 00133, Italy
Mariacristina Parravano, MD
- University of Rome “Tor Vergata”, Dipartimento di Biopatologie e Diagnostica per Immagini; Fondazione G.B. Bietti for the Study and Research in Ophthalmology, Rome, Italy.
Massimo G. Bucci, MD
- University of Rome “Tor Vergata”, Dipartimento di Biopatologie e Diagnostica per Immagini; Fondazione G.B. Bietti for the Study and Research in Ophthalmology, Rome, Italy.

Accepted 16 August 2004.

Purpose

To evaluate the ocular surface inflammatory response to the presence of preservatives in nonselective beta-blocker eyedrops.

Design

Prospective, crossover, single-masked, randomized clinical study.

Methods

study population: Twenty primary open-angle glaucoma or ocular hypertensive patients were divided in two groups, one treated with preservative-free timolol 0.5% (group 1) and the other with preserved timolol 0.5% (group 2) eyedrops. After 60 days of therapy and 3 more weeks of washout, the two groups switched to the other therapy. procedure: At each visit, basal tear samples were collected from the inferior conjunctival fornix for the determination of interleukin (IL)-1β tear concentrations by an enzyme-linked immunosorbent assay. Intraocular pressure measurement, conjunctival hyperemia, superficial punctate keratitis, and tear film breakup time were evaluated. main outcome measure: IL-1β concentration in tears following the use of preserved eyedrops.

Results

IL-1β tear concentrations increased significantly in both groups, compared with baseline values, during preserved timolol therapy. There were no statistically significant changes in hyperemia and superficial punctate keratitis throughout the study in either group. A statistically significant breakup time reduction was observed in both groups after 30 days and after 60 days of preserved therapy.

Conclusion

The use of preservatives in timolol 0.5% eyedrops leads to tear film instability and ocular surface inflammatory changes documented by a reduction of breakup time and an increase of IL-1β tear concentrations. Preservative-free beta-blockers are preferable for long-term hypotensive therapy to prevent ocular surface inflammation.