Conjunctival Goblet Cells, the Overlooked Cells in Glaucoma Treatment

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Daniel Tiedemann, Zaynab A Mouhammad, Tor P Utheim, Darlene A Dartt, Steffen Heegaard, Goran Petrovski, Miriam Kolko

Glaucoma is the leading cause of irreversible blindness worldwide. Although no definitive cure exists, lowering of the intraocular pressure decreases the rate of progression in the majority of patients with glaucoma. Anti-glaucomatous treatment modalities consist predominantly of chronic use of eye drops. It has become increasingly evident that long-term exposure to eye drops has a significant impact on the ocular surface, and thereby on patient compliance and quality of life. Maintenance of the ocular surface is highly dependent on a stable tear film. Conjunctival goblet cells of the ocular surface play an important role in providing the innermost mucin layer of the tear film and are essential for maintaining the ocular surface homeostasis. Recent studies have reported severe side effects of anti-glaucomatous drops on goblet cells. In particular, a preservative containing anti-glaucomatous drops have been shown to affect the viability and functions of the goblet cells. Furthermore, goblet cell density has been suggested as a potential predictor of surgical outcome following filtration surgery. The present review provides an overview of the current literature on the impact of anti-glaucomatous eye drops on goblet cells as well as the impact on the ocular surface. Moreover, the existing evidence of a possible association between goblet cell density and glaucoma filtration surgery outcome is summarized. We conclude that prostaglandin analogues spare the conjunctival goblet cells more compared to other anti-glaucomatous drops and that goblet cells may be a good predictor of surgical outcome following filtration surgery. Overall, given the multiple functions of goblet cells in the ocular surface homeostasis, dedicated strategies should be adopted to preserve this cell population during the course of glaucoma.

Original languageEnglish
JournalJournal of Glaucoma
Publication statusE-pub ahead of print - 2019

ID: 214264782