Conjunctival epithelial cell expression of interleukins and inflammatory markers in glaucoma patients treated over the long term

Purpose: To compare the conjunctival epithelial cell expressions of inflammatory cytokines in normal subjects and in glaucoma patients treated over the long term. Design: Case-control study. Participants: A total of 69 glaucoma patients treated over the long term and 15 normal subjects with no ocular abnormality or topical treatment. Methods: Amongst the 69 glaucoma patients, 27 were treated with preserved beta-blockers, 24 with unpreserved 0.5% timolol, and the other 18 patients with an association of greater than or equal to2 preserved drugs. All patients were treated for more than 1 year with the same treatment, with no significant differences between groups for mean ages and durations of treatment at the time of the study. Impression cytology specimens were taken and processed for immunofluorescence techniques. Conjunctival cell expressions of HLA DR, as a standard for inflammatory level, and the interleukins IL-6, IL-8, and IL-10 were obtained and quantified using flow cytometry. Main Outcome Measures: Immune markers and proinflammatory cytokines in impression cytology specimens. Results: We found a significantly increased expression of all immunoinflammatory markers and mediators in the conjunctival epithelium of glaucoma patients compared with normal eyes. Human leukocyte antigen DR was significantly higher in the 2 groups receiving preserved drugs than in the unpreserved timolol group. The 3 interleukins were similarly overexpressed in all glaucoma groups, with no significant between-groups differences except for the expression level of IL-8, which was significantly higher in the multitreatment group than in the preservative-free one. Conclusions: The present study confirms the increased expression of immunoinflammatory markers by the conjunctival epithelium of glaucoma patients treated over the long term. The development of nontoxic preservatives or preservative-free solutions is therefore of great interest. Ophthalmology2OO4;111:2186-2192(C)2004 by the American Academy of Ophthalmology.