{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T13:12:55Z","timestamp":1779282775488,"version":"3.51.4"},"reference-count":48,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NYEE Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: The aim of this study was to investigate the effects of intraocular pressure (IOP)-lowering drops on the sublayers of the human tear film as assessed by a novel nanometer-resolution Tear Film Imager (TFI, AdOM, Israel). Methods: In a prospective, cross-sectional study, 98 eyes from 56 adult human subjects were imaged using the TFI. The dataset included data from 18 eyes from 12 subjects treated with preserved IOP-lowering drops and 80 eyes from 44 control subjects not under ocular hypotensive therapy. Subjects in the IOP treatment group used a variety of IOP-lowering medications, including prostaglandin analogs, beta-blockers, carbonic anhydrase inhibitors, alpha agonists, and combination drops. A linear mixed effects model was used to assess the association between IOP-lowering therapy and tear film (TF) metrics, controlling for age and intra-individual correlation. The following parameters were measured: muco-aqueous layer thickness (MALT), muco-aqueous layer thinning rate (MALTR), lipid layer thickness (LLT), lipid map uniformity (LMU), inter-blink intervals (IBI), and lipid break-up time (LBUT). Results: Average ages significantly differed (p = 0.013) between the treatment group (66.5 years) and control group (average age 51.5 years), and thus results were adjusted for age accordingly. IOP was 17.1 mmHg in the treatment group and 16.1 mmHg in the control group. When analyzing the sublayers of the TF, MALTR had a significant association with IOP-lowering therapy after adjusting for age, with a difference of \u221252.68 nm\/s; 95% confidence interval [\u221296.87, \u22128.48]; p-value = 0.020. Additionally, IBI was significantly associated with IOP-lowering therapy after log transformation (p = 0.049), with shorter IBI in the treatment group. All other metrics (MALT, LLT, LMU, and LBUT) were statistically insignificant (p &gt; 0.05). Conclusions: These pilot results suggest that IOP-lowering drops may accelerate thinning of the TF, specifically the muco-aqueous layer. Longitudinal studies with significantly larger samples are needed to specify the differential impact of various ocular hypotensive therapies on the human TF and the clinical implications of these findings.<\/jats:p>","DOI":"10.3390\/diagnostics16101482","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T16:26:37Z","timestamp":1778689597000},"page":"1482","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effects of Intraocular Pressure-Lowering Drops on the Tear Film Assessed by a Novel High-Resolution Tear Film Imager"],"prefix":"10.3390","volume":"16","author":[{"given":"Alice","family":"Verticchio Vercellin","sequence":"first","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8073-1804","authenticated-orcid":false,"given":"Samuel","family":"Potash","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kira","family":"Manusis","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7129-2472","authenticated-orcid":false,"given":"Paul A.","family":"Sidoti","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard B.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brent A.","family":"Siesky","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keren","family":"Wood","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lily A.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"D\u2019Amelia","sequence":"additional","affiliation":[{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edan","family":"Kenig","sequence":"additional","affiliation":[{"name":"AdOM Advanced Optical Technologies Ltd., Lod 71520, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4725-998X","authenticated-orcid":false,"given":"Norman J.","family":"Kleiman","sequence":"additional","affiliation":[{"name":"Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Brenner","sequence":"additional","affiliation":[{"name":"Center for Radiological Research, Columbia University Irving Medical Center, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7798-7155","authenticated-orcid":false,"given":"George J.","family":"Eckert","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Tanga","sequence":"additional","affiliation":[{"name":"IRCCS-Fondazione Bietti, 00184 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0966-6311","authenticated-orcid":false,"given":"Carmela","family":"Carnevale","sequence":"additional","affiliation":[{"name":"IRCCS-Fondazione Bietti, 00184 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masako","family":"Chen","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Qi","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5178-6404","authenticated-orcid":false,"given":"Minwoo","family":"Kwon","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9897-4676","authenticated-orcid":false,"given":"Gal","family":"Antman","sequence":"additional","affiliation":[{"name":"Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"108115","DOI":"10.1016\/j.exer.2020.108115","article-title":"Biological functions of tear film","volume":"197","author":"Pflugfelder","year":"2020","journal-title":"Exp. 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