bimatoprost and Choroid-Diseases

Choroidal detachment (CD) is often observed at an early period particularly after trabeculectomy and glaucoma drainage implant surgery. However, topical antiglaucoma eye drop-induced CD is a rare complication. Here, we report a case of topical bimatoprost-induced late-onset CD after trabeculectomy and review the literature.. A 74-year-old man who suffered from primary open-angle glaucoma underwent his initial trabeculectomy with mitomycin-C in the right eye. Before the surgery, his intraocular pressure (IOP) was 20 to 22 mm Hg with bimatoprost 0.03%, dorzolamide 1%, and brimonidine 0.1% and his best corrected visual acuity (BCVA) was 0.9. The mean deviation in Humphrey Visual Field Analyzer (24-2 program) was -27.83 db. After successful trabeculectomy, IOPs were 11 to 16 mm Hg without any medication. Eight months after the surgery, we restarted bimatoprost to further reduce the IOP in the right eye, which was 15 mm Hg. At a hospital visit 2 months later, he complained of blurred vision that had persisted for the past 1 month; his IOP had decreased to 9 mm Hg. His BCVA was 0.04 and 3 quadrant CD was found. We discontinued bimatoprost and started him on betamethasone 0.1% 4 times per day. However, CD marginally changed after 1 week, with IOP at 7 mm Hg; thus, we performed scleral drainage for CD. After 3 weeks of drainage, CD completely disappeared. IOP increased to 16 mm Hg and BCVA was 0.7. However, 3 months after the drainage, IOP increased to 29 mm Hg, and needling revision was thus performed. After the surgery, IOP remained at 14 to 16 mm Hg without any glaucoma medication and CD recurrence. A review of the literature showed that various antiglaucoma medications induce CD, regardless of the preceding glaucoma surgery and that CD is usually resolved by withdrawing the medication and administering topical steroids. However, most previous studies have shown the recurrence of CD by rechallenging the same drug.. In our case, topical bimatoprost induced late-onset CD after trabeculectomy. Early scleral drainage may be a good option to quickly resolve drug-induced CD and prevent its recurrence. Therefore, it must be kept in mind that various antiglaucoma medications induce CD.

Topics: Aged; Antihypertensive Agents; Bimatoprost; Choroid Diseases; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Mitomycin; Trabeculectomy

To report two cases of choroidal detachment induced by topical bimatoprost.. Two males, aged 95 (case 1) and 74 years (case 2), were referred to our department for massive choroidal detachment. Case 1 was a one-eyed patient, and the affected eye of case 2 had undergone trabeculectomy 2 years previously. Both affected eyes were pseudophakic and treated for 6 months with topical bimatoprost/timolol fixed combination for open angle glaucoma (case 1) and pseudoexfoliation glaucoma (case 2). In both cases, symptoms appeared immediately after starting the drops and progressively worsened thereafter. In both affected eyes, moderate conjunctival hyperemia was noted, anterior segment examination and intraocular pressure were normal, and fundus examination revealed a massive choroidal detachment. This diagnosis was confirmed by B-scan ultrasonography. An adverse effect of bimatoprost was suspected, and the drug was discontinued, leading to the complete resolution of the choroidal detachment within 3 weeks in both eyes.. Choroidal detachment is a rare adverse effect which is not specific to bimatoprost but which has been also reported with the other prostaglandin analog drops. Its exact cause remains unclear, but is probably linked to the combination of enhanced uveoscleral outflow and pro-inflammatory properties. In all cases, the discontinuation of the prostaglandin analog led to the complete resolution of the choroidal detachment within 3 weeks.

Topics: Administration, Ophthalmic; Administration, Topical; Aged; Aged, 80 and over; Amides; Antihypertensive Agents; Bimatoprost; Choroid Diseases; Cloprostenol; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male

To report three cases of delayed choroidal detachment after treatment with topical prostaglandin analogs.. Intervention three case reports. Four eyes of three patients with chronic angle closure glaucoma developed choroidal detachment after using topical prostaglandin analogs.. Three patients with chronic angle closure glaucoma developed chroidal detachment in one week, three weeks and two years after using travoprost, bimatoprost and latanoprost respectively. All of them resolved after discontinuation of these medications. All of the eyes that developed chroidal detachment were pseudophakic.. Travoprost, bimatoprost and latanoprost may lead to choroidal detachment and hypotony. Pseudophakic patients may be at high risk of the development of chroidal detachment. Topical prostaglandin analogs should be used cautiously in these patients.

Topics: Administration, Topical; Aged; Amides; Bimatoprost; Choroid Diseases; Cloprostenol; Female; Glaucoma, Angle-Closure; Humans; Latanoprost; Lipids; Middle Aged; Ocular Hypotension; Prostaglandins F, Synthetic; Prostaglandins, Synthetic; Risk Factors; Time Factors; Travoprost