cloprostenol and Uveitis--Anterior

Bimatoprost 0.03% is an intraocular pressure (IOP) lowering prostaglandin analog with different adverse side effects such as potential ocular inflammatory effect and ocular hyperemia.. We report a case of 80-year-old woman diagnosed with bilateral glaucomatous uveitis, and choroidal detachment in the left eye after topical bimatoprost administration. During the patient's hospitalization, Bimatoprost treatment was discontinued and local steroid therapy was administrated. After 1 week we reported a marked improvement of visual acuity, IOP measurement was 12 mmHg in both eyes. Anterior segment examination showed complete resolution of conjunctival and pericheratic hyperemia with significant reduction of endothelial precipitates in both eyes.. In our case, the anterior granulomatous uveitis occurred in both pseudophakic eyes and the choroidal detachment (CD) in the eye that previously had trabeculectomy. Probably the scar tissue of the trabeculectomy allowed a better penetration of the Bimatoprost or a greater sensitivity due to an altered trabecular tissue. This work confirms that the onset physiopathology mechanism of granulomatous uveitis and CD following instillation of Bimatoprost remains uncertain.

Topics: Aged, 80 and over; Amides; Antihypertensive Agents; Bimatoprost; Choroidal Effusions; Cloprostenol; Female; Glaucoma; Humans; Hyperemia; Intraocular Pressure; Uveitis; Uveitis, Anterior

Topics: Aged; Antihypertensive Agents; Cloprostenol; Female; Glaucoma; Humans; Intraocular Pressure; Travoprost; Uveitis, Anterior

Topics: Adult; Antihypertensive Agents; Blood-Aqueous Barrier; Cloprostenol; Drug Synergism; Drug Therapy, Combination; Gonioscopy; Humans; Intraocular Pressure; Male; Ocular Hypertension; Timolol; Travoprost; Uveitis, Anterior

Topics: Aged; Cloprostenol; Exfoliation Syndrome; Female; Glaucoma; Humans; Ophthalmic Solutions; Travoprost; Uveitis, Anterior

To describe a previously unreported case of anterior granulomatous uveitis in a patient using bimatoprost.. A 72-year-old woman with a long-standing history of anisometropic amblyopia and pseudoexfoliative glaucoma in the right eye started therapy with bimatoprost 0.03% once a day in the right eye. She had no previous history of ocular inflammation or ocular surgery. Her medical history was negative for systemic diseases associated with ocular inflammation.. After one week, the patient developed severe conjunctival injection, cells and flare, and numerous 'mutton fat' keratic precipitates in the right eye. Examination of the left eye revealed no evidence of inflammation. Bimatoprost was discontinued; no topical steroid therapy was started. Systemic investigations were normal. The inflammation resolved over two weeks, solely with the discontinuation of bimatoprost.. Bimatoprost is a synthetic prostamide, chemically related to prostamide F. Prostamides are naturally occurring substances, biosynthesized from anandamide in a pathway that includes COX2. Even though anandamide has proven suggestive potential pro-inflammatory effects, the mechanism of induction of inflammation by bimatoprost remains uncertain and speculative. In our report, the onset of acute uveitis in a patient using bimatoprost, after a long-term and well-tolerated treatment with a prostaglandin analog, suggests a distinct potential pro-inflammatory action of prostamides. This can indirectly support the concept that the target receptor of bimatoprost is different, and that the mechanism of action of prostamides is pharmacologically unique.

Topics: Aged; Amides; Antihypertensive Agents; Bimatoprost; Cloprostenol; Exfoliation Syndrome; Female; Glaucoma; Granuloma; Humans; Intraocular Pressure; Lipids; Uveitis, Anterior

A 72-year-old man with long-standing bilateral glaucoma became refractory to levobunolol ophthalmic solution therapy after many years. Brimonidine was prescribed, but the patient developed a hypersensitivity several months later that was treated with loteprednol ophthalmic suspension. Bimatoprost was initiated 2 weeks later. Within an hour of the first dose of bimatoprost, the patient reported eye pain and photophobia that remained unresolved the following day. Examination revealed acute bilateral nongranulomatous anterior uveitis that was effectively treated with loteprednol. While observations in human and animal models suggest an association between certain prostaglandin-like agents and intraocular inflammation, this report is one of the first to suggest a link between bimatoprost and intraocular inflammatory reaction.

Topics: Aged; Amides; Antihypertensive Agents; Bimatoprost; Cloprostenol; Glaucoma; Humans; Intraocular Pressure; Lipids; Male; Uveitis, Anterior; Visual Acuity