INFLUENCE OF OPHTHALMOLOGICAL BACKGROUND ON THE SIDE EFFECTS OF OVERACTIVE BLADDER TREATMENT

Padilla-Fernández B1, Mallo-Muñiz B2, Hernández-Sánchez T3, Tinajas-Saldaña A3, Valverde-Martínez S4, Márquez-Sánchez M5, Lorenzo-Gómez A6, Müller-Arteaga C7, Muiños-Díaz Y7, Lorenzo-Gómez M2

Research Type

Clinical

Abstract Category

Overactive Bladder

Abstract 447
OAB: Medication and Sensation
Scientific Podium Short Oral Session 29
Saturday 21st November 2020
10:00 - 10:07
Pavilion 9
Overactive Bladder Female Pharmacology Retrospective Study
1. Hospital Universitario de Canarias, Universidad de La Laguna, 2. Universidad de Salamanca, 3. Complejo Asistencial Universitario de Salamanca, 4. Hospital Universitario de Ávila, 5. Instituto de Investigación Biomédica de Salamanca (IBSAL), 6. Complejo Asistencial de Zamora, 7. Hospital Universitario de Ourense
Presenter
M

María Fernanda Lorenzo-Gómez

Links

Abstract

Hypothesis / aims of study
It is advisable to consider ophthalmological disorders in women with overactive bladder (OAB) before the administration of pharmacological treatment in order to avoid iatrogenesis in ocular pathology.

Objectives: To describe the risk of dry eye or de novo conjunctivitis with different overactive bladder treatments in women.
Study design, materials and methods
Retrospective multicenter observational study of 1203 women treated for overactive bladder (OAB) before January 1st, 2019. Patients should have undergone at least an ophthalmologic review in the last year. Patients with amaurosis, amblyopia and retinal pathology were excluded. 

The patients were divided into three groups according to their ophtalmological background: 
GA (n = 255): patients with OAB and non-glaucoma eye disease; 
GB (n = 681): patients with OAB without ocular pathology; 
GC (n = 267): patients with OAB and glaucoma. 

Different OAB treatments were analysed (subgroups): 
1: Onabotulinum toxinA, 
2: Fesoterodine, 
3: Mirabegron, 
4: Oxybutynin, 
5: Pelvic floor muscle training (PFMT), 
6: Solifenacine, 
7: Tolterodine. 

Variables: age, BMI, evolution time, ASA, secondary diagnoses, eye health evolution. 
Descriptive statistics, Student's t, Chi2, Fisher, ANOVA, multivariate analysis, risk analysis; p <0.05 was considered significant.
Results
Mean age 64.48 years (range 19-85), lower in GB. Lower in GB; GA: average 70 years (41-82), lower in GA2: average GB 61.78 years (19-85), there were no differences in the subgroups; GC: average 66.02 years (49-78), was lower in GC1 and GC5. 

In the general sample, OAB treatment does influence the appearance of de novo eye disease. 

The risk of dry eye or conjunctivitis for each treatment in the general sample are:
- Fesoterodine: the risk is 0,12 less;
- Mirabregon: not significant;
- Oxybutynin: ethe risk is 0,53 less;
- PFMT: not significant;
- Solifenacine: the risk is 2,10 higher;
- Tolterodine: not significant. 

* Group A: higher risk with solifenacin (7.32), fesoterodine (4.80), oxybutynin (4.26),  mirabregon (2,75) and less with tolterodine (1,86).
* Group B: lower risk with oxybutynin (0,505), PFMT (0,279) and solifenacine (0,059). 
* Group C: no treatment showed a statistical significant influence on the appearance of de novo ocular pathology.

Psychiatric pathology: depression (%): GA-48.78, GB-21.95, GC-29.27; 
Anxiety (%): GA-71.43, GB-21.43, GC-7.14%. 
Fibromyalgia (%): GA-19.23, GB-30.77, GC-50.00. 
Prolapse (%): GA-5.88, GB-35.29, GC-58.82%.
Interpretation of results
It is well described that anticholinergics should be avoided in patients with high intraocular pressure, and that dry mouth and blurred vision may be disturbing side effects leading to treatment withdrawal. However, other ophthalmological disorders may also appear, like dry eye and recurrent conjunctivitis. Patients with glaucoma received more often PFMT for this reason, and patients with other ophtalmological disorders were more frequenlty treated with anticholinergics (Solifenacine, Oxybutynin, Tolterodine and Fesoterodine). On the other side, botulinum toxin and mirabegron were more often indicated in the group of patients with no ophtalmological background, but a higher incidence of diabetes mellitus was found in this group that could influence the treatment choice.
Concluding message
After 3 months of OAB treatment, nearly half of women suffered dry eye or de novo conjunctivitis, more frequently if they had no previous ophthalmic problem. They appeared sooner with oxybutynin and later with fesoterodine and mirabegron. If patients had previous ocular pathology other than glaucoma, all OAB treatments favored dry eye or conjunctivitis, but they were more frequent with solifenacine.
Disclosures
Funding None Clinical Trial No Subjects Human Ethics Committee Comité Ético de Investigación con Medicamentos del Complejo Asistencial Universitario de Ávila Helsinki Yes Informed Consent Yes