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Impact of mono- or multitherapy on ocular surface health and quality of life after 5 years of follow-up in the Glaucoma Intensive Treatment Study (GITS)

Jóhannesson, Gauti LU ; Lindén, Christina ; Aspberg, Johan LU orcid ; Andersson-Geimer, Sabina LU ; Heijl, Anders LU ; Bengtsson, Boel LU and Peters, Dorothea LU (2026) In Acta Ophthalmologica
Abstract

Aim: To evaluate the impact of initial mono- versus multitherapy on the ocular surface and related quality of life after 5 years follow-up in the Glaucoma Intensive Treatment Study (GITS). Method: The study included patients with primary open-angle glaucoma and pseudoexfoliation glaucoma who completed 5-year follow-up in GITS. Assessment of ocular surface disease (OSD) symptoms was done using a Swedish Translation of the OSD Index (OSDI). Signs of OSD were assessed with tear break-up time (BUT), Schirmer I test and staining using Lissamine green. Rasch analysis was used to analyse OSDI results. Results: Data on OSD symptoms were available at 5 years in 90% (219/242) of all participants initially included in GITS. Subjective or objective... (More)

Aim: To evaluate the impact of initial mono- versus multitherapy on the ocular surface and related quality of life after 5 years follow-up in the Glaucoma Intensive Treatment Study (GITS). Method: The study included patients with primary open-angle glaucoma and pseudoexfoliation glaucoma who completed 5-year follow-up in GITS. Assessment of ocular surface disease (OSD) symptoms was done using a Swedish Translation of the OSD Index (OSDI). Signs of OSD were assessed with tear break-up time (BUT), Schirmer I test and staining using Lissamine green. Rasch analysis was used to analyse OSDI results. Results: Data on OSD symptoms were available at 5 years in 90% (219/242) of all participants initially included in GITS. Subjective or objective OSD findings did not differ significantly between mono- and multitherapy. More than 90% of patients in both arms reported no or little subjective ocular surface problems and showed no or minimal staining with Lissamine green at the 60-month visit. Furthermore, 46% had normal BUT and 60% normal Schirmer tests. Use of preservative-free drops or need for additive lubricating tear drops did not differ between the arms. Conclusion: We found no differences in objective or subjective impact on ocular surface between the two randomization arms. However, a subgroup of glaucoma patients had more severe OSD irrespective of the amount of topical glaucoma treatment received, and this should be considered when choosing glaucoma therapy treatment in this subgroup by considering laser treatment or non-preserved eye drops.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
glaucoma, ocular surface disease, quality of life, treatment
in
Acta Ophthalmologica
publisher
Wiley-Blackwell
external identifiers
  • scopus:105029002782
  • pmid:41609297
ISSN
1755-375X
DOI
10.1111/aos.70078
language
English
LU publication?
yes
id
9b1ab0c7-282f-40f7-b5ab-ebe3cce7f408
date added to LUP
2026-02-23 13:36:16
date last changed
2026-02-24 03:00:02
@article{9b1ab0c7-282f-40f7-b5ab-ebe3cce7f408,
  abstract     = {{<p>Aim: To evaluate the impact of initial mono- versus multitherapy on the ocular surface and related quality of life after 5 years follow-up in the Glaucoma Intensive Treatment Study (GITS). Method: The study included patients with primary open-angle glaucoma and pseudoexfoliation glaucoma who completed 5-year follow-up in GITS. Assessment of ocular surface disease (OSD) symptoms was done using a Swedish Translation of the OSD Index (OSDI). Signs of OSD were assessed with tear break-up time (BUT), Schirmer I test and staining using Lissamine green. Rasch analysis was used to analyse OSDI results. Results: Data on OSD symptoms were available at 5 years in 90% (219/242) of all participants initially included in GITS. Subjective or objective OSD findings did not differ significantly between mono- and multitherapy. More than 90% of patients in both arms reported no or little subjective ocular surface problems and showed no or minimal staining with Lissamine green at the 60-month visit. Furthermore, 46% had normal BUT and 60% normal Schirmer tests. Use of preservative-free drops or need for additive lubricating tear drops did not differ between the arms. Conclusion: We found no differences in objective or subjective impact on ocular surface between the two randomization arms. However, a subgroup of glaucoma patients had more severe OSD irrespective of the amount of topical glaucoma treatment received, and this should be considered when choosing glaucoma therapy treatment in this subgroup by considering laser treatment or non-preserved eye drops.</p>}},
  author       = {{Jóhannesson, Gauti and Lindén, Christina and Aspberg, Johan and Andersson-Geimer, Sabina and Heijl, Anders and Bengtsson, Boel and Peters, Dorothea}},
  issn         = {{1755-375X}},
  keywords     = {{glaucoma; ocular surface disease; quality of life; treatment}},
  language     = {{eng}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Ophthalmologica}},
  title        = {{Impact of mono- or multitherapy on ocular surface health and quality of life after 5 years of follow-up in the Glaucoma Intensive Treatment Study (GITS)}},
  url          = {{http://dx.doi.org/10.1111/aos.70078}},
  doi          = {{10.1111/aos.70078}},
  year         = {{2026}},
}