dinoprost and Iris-Diseases

Topics: Administration, Topical; Aged; Amides; Bimatoprost; Cloprostenol; Cysts; Dinoprost; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Iris Diseases; Latanoprost; Pigment Epithelium of Eye; Prostaglandins F, Synthetic; Recurrence; Retreatment

The new glaucoma drugs latanoprost, isopropyl unoprostone, travoprost, and bimatoprost cause increased pigmentation of the iris in some patients. The purpose of the present article is to survey the available preclinical and clinical data on prostaglandin-induced iris pigmentation and to assess the phenomenon from a clinical perspective. Most of the data have been obtained with latanoprost, and it appears that there is a predisposition to latanoprost-induced iris pigmentation in individuals with hazel or heterochromic eye color. As latanoprost and travoprost are selective agonists for the prostaglandin F(2alpha) receptor, it is likely that the phenomenon is mediated by this receptor. Several studies indicate that latanoprost stimulates melanogenesis in iridial melanocytes, and transcription of the tyrosinase gene is upregulated. The safety aspects of latanoprost-induced iris pigmentation have been addressed in histopathologic studies, and no evidence of harmful consequences of the side effect has been found. Although a final assessment of the clinical significance of prostaglandin-induced iris pigmentation currently is impossible to make, it appears that the only clear-cut disadvantage is a potential heterochromia between the eyes in unilaterally treated patients because the heterochromia is likely to be permanent, or very slowly reversible.

Topics: Amides; Animals; Antihypertensive Agents; Bimatoprost; Cloprostenol; Dinoprost; Eye Color; Gene Expression Regulation; Humans; Iris; Iris Diseases; Latanoprost; Lipids; Melanocytes; Monophenol Monooxygenase; Pigmentation Disorders; Prostaglandins F, Synthetic; Receptors, Prostaglandin; Travoprost; Up-Regulation

To compare incidence of iridial pigmentation prospectively induced by long term treatment with latanoprost and isopropyl unoprostone (hereafter, unoprostone) in Japanese patients with glaucoma.. Patients with glaucoma treated with prostaglandin (PG) related ophthalmic solutions were sequentially enrolled. Patients treated for more than 30 months with PG related ophthalmic solutions were subjected to analysis. The entry criteria were no history of intraocular surgery, laser iridotomy, and/or laser trabeculoplasty within 12 months before and after the enrolment; and no history of uveitis; no changes in antiglaucoma drugs within 6 months before and after the enrolment. Photographs of the irides were taken under the same conditions and three glaucoma specialists evaluated the iridial pigmentation with masking of patient information. The correlation of iridial pigmentation with the background factors and the reduction of intraocular pressure (IOP) before and after the treatment were investigated.. 48 eyes in 48 patients satisfied the enrolment criteria (25 eyes in the latanoprost group, 23 eyes in the unoprostone group). At the end of the follow up period, iridial pigmentation was present in 15 patients (60.0%) in the latanoprost group and seven patients (30.4%) in the unoprostone group. The correlation between development of iridial pigmentation and age, sex, concurrent use of other ophthalmic solutions, and IOP reduction was not significant.. The incidence of iridial pigmentation induced by latanoprost or unoprostone is high in the case of long term treatment. Iridial pigmentation did not affect PG related ophthalmic solution induced IOP reduction.

Topics: Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Dinoprost; Eye Color; Female; Follow-Up Studies; Glaucoma; Humans; Iris Diseases; Latanoprost; Male; Middle Aged; Ophthalmic Solutions; Pigmentation Disorders; Prospective Studies; Prostaglandins F, Synthetic; Risk Factors

Changes in iris color have been noted anecdotally after cataract surgery in infants, but they have not been studied systematically. The mechanism for these iris color changes has not previously been reported in the biomedical literature.. Photographs were taken of both eyes of 15 children and 11 rhesus monkeys who had undergone unilateral cataract surgery. Masked examiners reviewed the photographs and compared the iris color of the eyes that were operated on with the eyes that were not operated on. Between 4 and 6 weeks postoperatively, the level of prostaglandin F(2alpha) in the aqueous humor (n = 4) and vitreous humor (n = 2) was measured in both the operated and nonoperated eyes of 4 monkeys that had undergone a neonatal lensectomy during the first 5 days of life.. Thirteen of 15 children had a darker iris color in the operated eye in relation to the nonoperated (control) eye. Four of 11 monkeys had a uniformly darker iris in the operated eye; the other 7 monkeys had regional darkening or patches of darker iris in the eye that was operated on. The prostaglandin F(2alpha) levels in neonatal monkeys were higher in the aqueous humor and in the vitreous humor of the operated eye in relation to the nonoperated eye.. In some children, cataract surgery is associated with a darkening of the iris color in the operated eye. We speculate that this darkening results from an exuberant prostaglandin release stimulated by the cataract surgery and may occur through the same or a similar mechanism by which latanoprost causes the darkening of iris color.

Topics: Animals; Animals, Newborn; Aqueous Humor; Cataract Extraction; Child; Child, Preschool; Dinoprost; Eye Color; Female; Humans; Infant; Iris Diseases; Macaca mulatta; Male; Pigmentation Disorders; Retrospective Studies; Vitreous Body

Latanoprost, a new ocular hypotensive prostaglandin F2 alpha analogue prodrug, was found to induce increased pigmentation of monkey irides in chronic toxicity studies. This prompted us to investigate the effect of naturally occurring prostaglandins on the monkey iris to determine whether this pigmentary effect is unique for latanoprost or whether it is a class effect of prostaglandins. PGF2 alpha-isopropyl ester (IE), PGE2-IE and latanoprost were applied topically to cynomolgus monkey eyes for 18-44 weeks. One eye of each animal was treated, while the other served as control. In addition, latanoprost was applied to sympathectomized monkey eyes. PGF2 alpha-IE, PGE2-IE, as well as latanoprost, induced increased pigmentation in the monkey eye. The first signs of this effect were seen after about two months of treatment. Latanoprost also induced increased pigmentation in sympathectomized eyes. It is concluded that both naturally occurring prostaglandins and their synthetic analogues can induce increased iridial pigmentation in cynomolgus monkeys, and that the effect does not require the presence of sympathetic nerves.

Topics: Administration, Topical; Animals; Dinoprost; Dinoprostone; Eye Color; Iris; Iris Diseases; Latanoprost; Macaca fascicularis; Melanosis; Ophthalmic Solutions; Pigment Epithelium of Eye; Prostaglandins; Prostaglandins F, Synthetic; Sympathectomy

To present a case in which iris pigmentation developed after treatment with isopropyl unoprostone, an analogue of a prostaglandin metabolite.. Case report.. A Japanese man with dark brown irises, treated unilaterally with isopropyl unoprostone, developed iris-color change in the treated eye after a 20-month treatment.. Isopropyl unoprostone can induce iris pigmentation as does latanoprost.

Topics: Administration, Topical; Dinoprost; Eye Color; Follow-Up Studies; Glaucoma; Humans; Iris; Iris Diseases; Male; Middle Aged; Ophthalmic Solutions