Aims: To investigate ocular surface morphology and the expression of
inflammatory markers HLA-DR
in impression cytology (IC) specimens from patients receiving topical antiglaucoma monotherapy.
Methods: IC specimens were
obtained from patients taking no topical medication (n =13)and from primary open-angle
glaucoma or ocular
hypertensive patients taking one
topical medication
for at least 3 months (latanoprost n = 14; betaxolol n = 12; timolol n = 14). The morphology of epithelial
cells and goblet cell
density was evaluated by light
microscopy. The expression of HLA-DR on epithelial cells and T-lymphocytes was
analysed by flow cytometry.
Results: A significant increase in HLA-DR on epithelial cells in patients on
monotherapy was detected
(latanoprost P<.05; betaxolol P<.01; timolol P<.05). The epithelial cells had a normal nuclear
cytoplasmic ratio of 1:3 and
there were no significant changes in goblet-cell density between
monotherapy groups and control.
Conclusions: In patients
with long-term monotherapy
no changes of ocular surface
morphology were observed. The flow cytometric results indicate that administration of a single topical
medication preserved with
benzalkonium chloride, irrespective of
type, for
3 months or more induced a significant degree of subclinal inflammation detected as
increased expression of HLA-DR on conjunctival epithelial cells.