Prostaglandin analogues: A double-edged sword in orbital glaucoma disease management

2020 ◽  
pp. 112067212090529
Author(s):  
Varajini Joganathan ◽  
Paul S Cannon ◽  
Karl Mercieca
Keyword(s):  
Intraocular Pressure ◽  
Adverse Effects ◽  
Ocular Hypertension ◽  
Pressure Rise ◽  
Eye Drops ◽  
Prostaglandin Analogue ◽  
Prostaglandin Analogues ◽  
Patient Reported ◽  
The Aesthetic ◽  
Orbital Disease

Introduction: The authors describe benefits of the recognised adverse effects of prostaglandin analogues on periocular structures in patients with unilateral proptosis and intraocular pressure rise. This case points to intentional consideration of prostaglandin analogue therapy in this selected cohort of patients with secondary ocular hypertension and proptosis. Case description: A 70-year-old gentleman who presented with a 1-week history of a red and painful right eye associated with tortuous and dilated episcleral blood vessels. Visual acuity was unaffected. A diagnosis of idiopathic orbital inflammatory disease was made by extraocular muscle biopsy. Two weeks later, the patient presented with worsening pain, reduced vision and raised intraocular pressure. The secondary ocular hypertension was successfully treated with topical preserved eye drops, including latanoprost, a prostaglandin analogue. Over 6 months, the patient developed drop intolerance and punctate keratopathy leading to therapy non-adherence. Interestingly, the patient reported improvement in periocular appearance related to prostaglandin-associated periorbitopathy. Ocular surface disease and intraocular pressures were subsequently managed with preservative-free eye drops. Conclusion: Secondary ocular hypertension is not an uncommon consequence of orbital disease. Prostaglandin analogue can act as a double-edged sword in the management of raised intraocular pressure by reducing eye pressure at the cost of developing adverse effects of prostaglandin-associated periorbitopathy. These adverse effects however can be beneficial in the aesthetic rehabilitation of proptosis and associated exposure keratopathy in patients with unilateral orbital disease and probably should be sought as first line treatment in those with proptosis and raised intraocular pressure.

Objective ocular surface tolerance in patients with glaucoma treated with topical preserved or unpreserved prostaglandin analogues

2018 ◽  
Vol 29 (6) ◽  
pp. 645-653 ◽  
Author(s):  
Ammar El Ameen ◽  
Guillaume Vandermeer ◽  
Raoul K Khanna ◽  
Pierre-Jean Pisella
Keyword(s):  
Intraocular Pressure ◽  
Prostaglandin Analogue ◽  
Ocular Toxicity ◽  
Prostaglandin Analogues ◽  
Conjunctival Hyperaemia ◽  
Ocular Symptoms ◽  
Tear Meniscus ◽  
Tear Meniscus Height ◽  
Preservative Free ◽  
Ocular Signs

Purpose: Preservatives in glaucoma medications have been associated with ocular toxicity. We compared ocular signs and symptoms in patients with open-angle glaucoma or ocular hypertension treated in monotherapy with preserved or preservative-free prostaglandin analogues. Methods: Observational cross-sectional clinical study in real life. 82 patients treated for at least 6 months with prostaglandin analogue were assessed for intraocular pressure, ocular symptoms and ocular signs including conjunctival hyperaemia, tear break-up time and tear meniscus height measured using objective and non-invasive methods (OCULUS Keratograph 5M). Patients presenting with symptoms of ocular toxicity with preserved prostaglandin analogues were switched to preservative-free latanoprost, and a second assessment was processed 6 months after. Results: At inclusion, 30 (36.6%) patients were treated with preservative-free latanoprost, 25 (30.5%) with preserved latanoprost, 16 (19.5%) with preserved travoprost and 11 (13.4%) with preserved bimatoprost. Patients treated with preservative-free latanoprost reported significantly less ocular symptoms upon instillation (mainly burning) and between instillations than patients treated with preserved prostaglandin analogues. The mean conjunctival hyperaemia (limbal + bulbar) was significantly lower with preservative-free latanoprost (2.08 ± 0.55) compared to preserved latanoprost (2.50 ± 0.7, p = 0.0085), preserved travoprost (2.67 ± 0.82, p = 0.0083) and preserved bimatoprost (2.68 ± 0.67, p = 0.0041). There were no relevant between-group differences in mean tear meniscus height and break-up time. Ocular symptoms and conjunctival hyperaemia improved when preserved prostaglandin analogues were switched to preservative-free latanoprost for 6 months while intraocular pressure reduction was maintained. Conclusion: Overall, this study suggests a better subjective and objective ocular tolerance when patients were treated with preservative-free latanoprost than with other preserved prostaglandin analogues monotherapy. Switching to preservative-free latanoprost maintained intraocular pressure at the same level as preservative prostaglandin analogue, but improved ocular surface tolerance.

scholarly journals Preservative-free versus preserved latanoprost eye drops for reducing intraocular pressure: a non-inferiority phase III randomized, multi-center, single-blind, parallel-group controlled trial

2021 ◽  
Vol 9 (4) ◽  
Author(s):  
Panos Theodosiadis ◽  
Anastasios Konstas ◽  
Ioannis Halkiadakis ◽  
Vasiliki Dimera ◽  
Dimitrios Koufakis ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Ocular Hypertension ◽  
Open Angle Glaucoma ◽  
Ophthalmic Solution ◽  
Phase Iii ◽  
Point Estimate ◽  
Eye Drops ◽  
Open Angle ◽  
Parallel Group ◽  
Preservative Free

Background: The aim of this study was to test the non-inferiority of preservative-free (PF) latanoprost 50 μg/mL multi-dose ophthalmic solution versus the marketed benzalkonium chloride (BAK)-preserved latanoprost 50 μg/mL ophthalmic solution in patients with open-angle glaucoma and patients with ocular hypertension. Methods: This was a prospective, national, randomized, multi-center, observer-blind, parallel-group controlled clinical trial. Patients were randomized to receive either PF or BAK-preserved latanoprost once daily for 12 weeks. The primary endpoint was the change in intraocular pressure (IOP) at 8:00 AM in the affected eye between the end of the treatment (week 12) and the baseline (week 0). Secondary measurements were taken at weeks 2 and 6, with IOP being recorded at 8:00 AM, 12:00 PM, and 4:00 PM. Results: A total of 158 patients were included in the per protocol (PP) population (77 in the PF latanoprost treatment arm and 81 patients in the BAK-preserved latanoprost treatment arm). PF latanoprost was non-inferior to BAK-preserved latanoprost in reducing IOP at 8:00 AM in the study eye from the baseline (week 0) to the end of the treatment (week 12). The point estimate of the between-treatment difference was 0.1 mmHg (95% confidence interval: -0.646, 0.847). Mean between-group differences in IOP reduction from the baseline to each of the secondary measurements were also similar between the two treatment arms. The two treatments were well tolerated and had comparable adverse event profiles. Conclusions: PF latanoprost was non-inferior to BAK-preserved latanoprost in reducing IOP in patients with open-angle glaucoma or ocular hypertension. Both treatments were well tolerated.

SYNCHRONIZATION OF ESTRUS AND OVULATION IN CATTLE WITH THE PROSTAGLANDIN ANALOGUE AY 24655

1977 ◽  
Vol 57 (1) ◽  
pp. 23-32 ◽  
Author(s):  
K. J. BETTERIDGE ◽  
E. A. SUGDEN ◽  
M. D. EAGLESOME
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Estrous Cycle ◽  
Luteal Phase ◽  
Single Injection ◽  
Prostaglandin Analogue ◽  
Plasma Progesterone ◽  
Prostaglandin Analogues ◽  
Adverse Side Effects ◽  
Dairy Heifers

In 97 experiments, cattle (mostly dairy heifers) were treated with AY24655 by intrauterine (i.ut.), subcutaneous (s.c.) or intramuscular (i.m.) routes during the luteal phase of the estrous cycle. Responses were assessed by observation for estrus and ovarian palpation in 97 cases, plasma progesterone determinations in 84 and by inspection of the ovary in 41. Doses of 10–50 mg i.ut. led to dose-related responses but inadequate synchronization. Both animals receiving 40 + 8 mg s.c. at 24-h intervals were synchronized, but 50 mg as a single i.m. injection was inadequate (2/5 synchronized). A dose of 100 mg i.m. was effective as a single injection (37/40 synchronized) or as two 6-h-spaced injections (8/10 synchronized). Progesterone concentrations showed sustained declines in all 61 synchronized animals and temporary declines in 15/23 non-synchronized animals. Ten of 18 synchronized animals became pregnant when used as recipients of embryos. Ten of 13 treated animals were synchronized by 100 mg following PMSG treatment for superovulation and 13/22 embryos transferred from these donors survived. Adverse side effects were confined to one batch of the compound which may have been impure. Though less potent than some prostaglandin analogues, AY24655 compared favorably with them for synchronizing cattle without marked adverse effects on embryos.

scholarly journals Topical Ripasudil as First Line Treatment for Ocular Hypertension in Uveitis Cases: AnAnalytic Study

2021 ◽  
Author(s):  
Harvinder NagpaL ◽  
Mandeep Kaur
Keyword(s):  
Intraocular Pressure ◽  
Ocular Hypertension ◽  
Tertiary Care ◽  
Eye Drops ◽  
Care Hospital ◽  
Line Treatment ◽  
First Line ◽  
Detailed Medical History ◽  
Anti Inflammatory ◽  
First Line Treatment

Introduction: Uveitis can directly or indirectly lead to ocular hypertension which can lead to glaucoma. Ripasudil has a different mechanism of action than other anti-glaucoma medications available commercially and in contrary to these drugs, ripasudil also has anti-inflammatory properties providing an upper edge over other intraocular pressure lowering drugs. In addition to primary glaucoma, these new Rho kinase associated inhibitors can provide satisfactory results in glaucoma with secondary pathologies. Aim: To study the role of ripasudil as first line treatment for ocular hypertension in uveitis cases. Materials and Methods: A prospective randomised study comprising 40 patients of Ocular Hypertension (OHT) associated with uveitis was conducted in the Outpatient Department (OPD) of Ophthalmology at a tertiary care hospital in North India from October 2020 to January 2021. The diagnosis of uveitis was made clinically with detailed medical history and slit lamp biomicroscopic examination. All the diagnosed patients were started with topical ripasudil hydrochloride hydrate 0.4% eye drops twice daily along with anti-inflammatory medications. Intraocular Presure (IOP) was recorded after 4 weeks and 12 weeks at 8 am, 10 am and 4 pm. Effectiveness of the drugs was calculated in terms of mmHg fall in mean intraocular pressure using t-test and p-values. Results: Out of 40 patients with uveitis associated OHT, 20caseswere inflammation related (mean age was 56.2±16.3years,13 males, 7 females) and 20 cases were categorised as corticosteroid induced (mean age was 58.9±15.69 years, 14 males, 6 females). At 12 weeks there was 5.67±0.59 mmHg fall in IOP (22.70%) in inflammation related OHT and there was 6.37±0.07 mmHg fall in IOP (25.34%) in corticosteroid related OHT. There was statistically significant fall in IOP (p-value=0.001). Conclusion: This study demonstrated that topical ripasudil hydrochloride hydrate 0.4% eye drops is effective in lowering the IOP, also there were no side effects, so it is safe and well-tolerated. So, ripasudil can provide a safe and effective alternative for lowering of IOP among uveitis related OHT.

scholarly journals The Efficacy and Safety of Preservative-containing and Preservative-free Brimonidine-Timolol Fixed Combination in Normal Tension Glaucoma

2021 ◽  
Vol 62 (10) ◽  
pp. 1407-1414
Author(s):  
Bo Kyung Kim ◽  
Si Nae Kim ◽  
Joon Mo Kim
Keyword(s):  
Intraocular Pressure ◽  
Adverse Effects ◽  
Fixed Combination ◽  
Normal Tension Glaucoma ◽  
Eye Drops ◽  
Efficacy And Safety ◽  
Timolol Maleate ◽  
Combination Drug ◽  
Brimonidine Tartrate ◽  
Preservative Free

Purpose: To analyze the efficacy and safety of preservative-containing and preservative-free 0.2% brimonidine tartrate and 0.5% timolol maleate fixed combination drug in normal tension glaucoma.Methods: Fifty-one patients (84 eyes) who were diagnosed with normal tension glaucoma and with preservative-containing or preservative-free brimonidine-timolol fixed combinations alone were analyzed retrospectively from January 2017 to February 2020. Intraocular pressure (IOP) was measured four times a day (9 a.m., 11 a.m., 2 p.m., and 4 p.m.) before and at 6 months after applying eye drops. We analyzed and compared the effect of lowering IOP and the occurrence of intra or extra-ocular adverse effects.Results: A significant mean IOP reduction was shown in both groups: -1.95 ± 2.50 mmHg (-12.26 ± 15.87%) in the preservative-containing group and -1.60 ± 2.06 mmHg (-10.54 ± 13.94%) in the preservative-free group at 6 months after eyedrop instillation. The IOP was lowest in both groups at 11 a.m. There were no significant differences between the two groups in lowering IOP. Serious adverse effects causing discontinuation of the eye drops were not observed.Conclusions: Both preservative-containing and preservative-free brimonidine-timolol fixed combinations are effective in lowering IOP in normal tension glaucoma patients and are considered to be effective as eye drops without serious adverse effects.

scholarly journals Fixed combination bimatoprost-timolol in prevention of ocular hypertension after phacoemulsification of uncomplicated cataract

2016 ◽  
Vol 9 (2) ◽  
pp. 69-73
Author(s):  
Igor’ B Alekseev ◽  
Bella N Khatsukova ◽  
Marija M Soshina ◽  
Nadezhda I Samokhina ◽  
Julija A Nam ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Ocular Hypertension ◽  
Postoperative Period ◽  
Fixed Combination ◽  
Corneal Edema ◽  
Main Group ◽  
Control Group ◽  
Surgical Trauma ◽  
Eye Drops

To date, cataract surgery development aims at minimizing surgical trauma in order to achieve a quicker rehabilitation. However, one of the severe complications of cataract surgery is increased intraocular pressure due to the inflammatory response, the so-called reactive syndrome that occurs in the early postoperative period. Aim of the study was to evaluate the efficacy of a fixed combination of bimatoprost and timolol (Ganfort) eye drops in prevention of ocular hypertension and corneal edema after ultrasonic phacoemulsification. Materials and methods. The study included 60 patients (60 eyes) with uncomplicated cataracts of varying maturity degree. All patients were divided into 2 groups. Patients in the main group (30 patients, 30 eyes, 20 female and 10 male) underwent pneumotonometry before surgery and received a single instillation of Ganfort, and pneumotonometry was performed again 30 minutes after instillation (before surgery), and then again after surgery. Patients in the control group (30 patients, 30 eyes, 19 female and 11 male) underwent pnemotonometry before and after surgery. Results. The postoperative period was similar in both groups. On the first day after surgery, mean intraocular pressure in patients of the main group was 12.9 mmHg while in the control group the mean intraocular pressure was 20.1 mmHg. In patients of the main group, intraocular pressure decreased by 1/3 with Ganfort therapy on the first day after surgery, and biomicroscopic corneal findings were less pronounced in the main group compared to the control group. Conclusion. The results of our study show that even uncomplicated cataract phacoemulsification with IOL implantation leads to a reactive postoperative increase of intraocular pressure from 17.5 to 20.1 mmHg. In our study, the use of Ganfort did not cause side effects or intolerability. Ganfort use may be considered as an effective prophylactics of ocular hypertension and corneal edema after ultrasonic phacoemulsification.

scholarly journals Ocular Surface Changes in Prostaglandin Analogue-Treated Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Wencui Shen ◽  
Bingqing Huang ◽  
Jin Yang
Keyword(s):  
Intraocular Pressure ◽  
Ocular Surface ◽  
Prostaglandin Analogue ◽  
First Line ◽  
Prostaglandin Analogues ◽  
First Line Therapy ◽  
Line Therapy ◽  
Ocular Changes ◽  
The Relationship ◽  
Surface Changes

Glaucoma is the second leading cause of blindness globally. Reducing intraocular pressure (IOP) has been acknowledged to be the main therapy for glaucoma. Prostaglandin analogues (PGAs) have become the first-line therapy for patients with glaucoma due to their powerful efficacy for lowering (IOP). However, usage of PGAs can also cause several notable side effects, including the changes in ocular surface. The relationship between PGAs and ocular surface changes is complicated and still remains unclear. In the present review, we summarize the recent studies of the effects of PGAs on ocular changes as well as the possible mechanisms that might provide new considerations during clinical medication.

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