latanoprost and Hyperpigmentation

Latanoprost is a prostaglandin F2α analogue, which has been used as a first-line drug for open-angle glaucoma. Common side effects of latanoprost include hyperpigmentation. While it usually occurs on irides or periocular skin, diffuse facial hyperpigmentation is rarely reported.. A 71-year-old woman was presented with diffuse gray-brown colored maculopatches on her face. The symptom appeared 1 week after she started to use latanoprost eye drops for glaucoma. Biopsy specimen revealed vacuolar degeneration of dermo-epidermal junction and pigment incontinence in dermis.. The aim of this paper is to introduce a rare adverse effect of latanoprost and effective way of treatment.. We stopped her from using latanoprost. She was also treated with 532-nm potassium titanyl phosphate laser and low-fluence 1064-nm Q-switched Nd:YAG laser, while using topical agents.. After 10 weeks, we observed hyperpigmentation of her face was effectively and safely treated. The patient was satisfied with the result.. Diffuse facial pigmentation could be one of the latanoprost-induced adverse effects and the laser treatments with topical agents we used can make it improve faster.

Topics: Administration, Cutaneous; Administration, Ophthalmic; Aged; Antihypertensive Agents; Biopsy; Brimonidine Tartrate; Dermatologic Agents; Drug Substitution; Face; Female; Glaucoma; Humans; Hyperpigmentation; Lasers, Solid-State; Latanoprost; Low-Level Light Therapy; Ophthalmic Solutions; Skin; Skin Pigmentation; Treatment Outcome

To evaluate the periocular changes due to topical bimatoprost and latanoprost use and to investigate their effects on the lacrimal drainage system.. All participants (69 eyes of 43 patients, 52 eyes of 26 controls) were classified into three groups: bimatoprost (0.03%) users, latanoprost (0.005%) users, and healthy controls. Each patient was examined before prostaglandin therapy, and then at the first, third, sixth, and twelfth month of therapy. Palpebral fissure height, upper eyelid crease, and levator function were measured, and lacrimal system drainage irrigation was performed. Periocular hyperpigmentation and upper eyelid sulcus were also examined.. No significant change was identified in palpebral fissure height or levator function in any group. However, in upper eyelid crease, among bimatoprost users, a statistically significant increase was observed when compared to the control group (P < 0.001). Patients with skin type II and III, in bimatoprost users, and patients with skin type III, in latanoprost users, had statistically significant hyperpigmentation (P < 0.001) after the third month of therapy. During follow-up, no lacrimal drainage system obstruction was seen.. Topical bimatoprost therapy causes more periocular changes than latanoprost therapy. Thus, in unilateral cases, patients should be well informed about these probable changes before therapy.

Topics: Aged; Amides; Antihypertensive Agents; Bimatoprost; Cloprostenol; Eyelid Diseases; Female; Glaucoma; Humans; Hyperpigmentation; Incidence; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Prospective Studies; Prostaglandins F, Synthetic; Turkey

The purpose of the present study was to investigate the incidence and severity of iridial pigmentation under latanoprost topical use on brown eyes in Taiwan.. Retrospective review study was conducted from April 1999 to October 2001 in the Department of Ophthalmology, Taipei Veterans General Hospital, Taiwan, for glaucoma clinic monthly follow-up patients; 140 open-angle glaucoma patients on 0.005% latanoprost were enrolled. Analyses of iridial pigmentation incidence, grading, patient age distribution, side effect, and time course were performed. Boys-Smith pigment gradation lens was used as standard for semiquantitative iris pigmentation grading.. Before 0.005% latanoprost use, 90% of the patients enrolled were noted with iridial pigmentation grade I, and 10% were with grade I-II, but not reaching grade II scale standard. A total of 60 patients on 0.005% latanoprost developed increased pigmentation of the iris during the follow-up period. An increase of iris pigmentation was noted after an average of 7.27 months use of latanoprost (range 1-19 months, SD 2.65 months). For iridial pigmentation grading, 57.1, 30.7, 10.0, and 2.1% of our patients were noted to have grade I, II, III, and IV respectively. Most patients with latanoprost-induced iris hyperpigmentation were with grade II iridial pigmentation. There were 15 patients (10.7%) (10 female and five male) with hypertrichosis in the study group who were not compatible with the iridial pigmentation status. Among these patients, female patients had higher incidence of hypertrichosis than males, but this did not bother them. Only four patients (2.8%) were with conjunctiva chemosis and three patients (2.1%) with lid margin hyperpigmentation.. Contrary to the belief that latanoprost rarely caused iris hyperpigmentation in yellow-brown eyes, our study showed that 42.8% iris hyperpigmentation did occur, especially after continual use for around 7 months. Higher hyperpigmentation incidence were noted in male than in female patients. This might be due to stronger adrenergic incidence in male than in female patients. Although hypertrichosis and increasing eyelid pigmentation together with iridial pigmentation represented a potentially permanent cosmetic side effect, they are very rare and occurred in no more than 3% in our patients. It is a good way to take Boys-Smith pigment gradation lens for iridial pigmentation grading and for long-term continual evaluation. The doctors should exert great care in differentiating drug-induced iris pigmentation and iris nevi from early stage uveal melanoma.

Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Antihypertensive Agents; Child; Female; Glaucoma, Open-Angle; Humans; Hyperpigmentation; Hypertrichosis; Iris Diseases; Latanoprost; Male; Middle Aged; Prostaglandins F, Synthetic; Retrospective Studies; Severity of Illness Index

This study aimed to determine whether the longterm use of latanoprost is associated with an increase in trabecular pigmentation, especially in subjects in whom iris pigmentation has increased.. We enrolled 50 subjects for whom treatment was to start for ocular hypertension, primary open-angle glaucoma or normal tension glaucoma. All subjects received latanoprost 0.005% daily. Trabecular pigmentation was documented using gonioscopic photography of the inferior quadrant at baseline, every 3 months for the first year and every 6 months for the second and third years. Three glaucoma specialists evaluated the series of gonioscopic photographs for each eye of each subject in a masked fashion. The intraocular pressure (IOP) was also recorded at each visit.. A total of 41 subjects (79 eyes) completed 3 years of follow-up, and none showed any increase in the grade of trabecular pigmentation, including 10 subjects (20 eyes) in whom the iridial pigment increased.. Although latanoprost increased iridial pigmentation in some subjects, we found no evidence of an increase in trabecular pigmentation over the 3 years of follow-up.

Topics: Antihypertensive Agents; Glaucoma, Open-Angle; Gonioscopy; Humans; Hyperpigmentation; Intraocular Pressure; Iris Diseases; Latanoprost; Middle Aged; Ocular Hypertension; Photography; Prostaglandins F, Synthetic; Trabecular Meshwork

To report increased eyelid pigmentation as an adverse side effect associated with topical ocular hypotensive lipids in African Americans.. Interventional case series.. Two African-American patients with open-angle glaucoma are described in whom increased eyelid pigmentation developed 1 month to 5 months after beginning treatment with either latanoprost or bimatoprost.. Latanoprost was discontinued in an African-American patient, and pigmentation gradually diminished by 3 months after cessation of latanoprost. Increased eyelid pigmentation and increased eyelash length were noted in another African-American patient after just 4 weeks on bimatoprost.. An increase in eyelid pigmentation and eyelash growth is a possible complication of topical ocular hypotensive lipid therapy, even in African-American patients. The changes seems to present earlier after bimatoprost treatment then after latanoprost treatment. Cessation of these medications may lead to loss of induced pigmentation.

Topics: Amides; Antihypertensive Agents; Bimatoprost; Black People; Cloprostenol; Eyelid Diseases; Female; Glaucoma, Open-Angle; Humans; Hyperpigmentation; Intraocular Pressure; Latanoprost; Lipids; Middle Aged; Prostaglandins F, Synthetic; Skin Pigmentation

Latanoprost, a prostaglandin F(2alpha)-analogue, has been widely in use in clinical practice for a period of over 5 years. The side-effects of latanoprost are analyzed and the clinical relevance is discussed.. Hypertrichosis and increased pigmentation of eyelashes will develop in the majority of patients using latanoprost for more than 6 months. Increased pigmentation of the eyelids may also occur. Hyperpigmentation of the iris is seen in 12-18% of caucasians using latanoprost over a period of 1-2 years. Increased iris pigmentation seems more common in asian people and remains unchanged after discontinuation of therapy. Pigmentation of intra- and extraocular structures is caused by increased melanogenesis, not by melanocyte proliferation. Mild conjunctival hyperemia may develop in approximately 30% of patients, but is most often without clinical relevance. Further reported side-effects include anterior uveitis, reactivation of herpes-keratitis/-dermatitis and cystoid macular edema in pseudophakic and aphakic patients. A causal relationship has still not been proven for these side-effects. Systemic side-effects are rare (e.g. headache, facial rash, cardiovascular effects). No experience exists for treatment of glaucoma with latanoprost in childhood.. Latanoprost represents a highly effective antiglaucomatous drug, rarely associated with vision-threatening complications. The most common complications are hypertrichosis of eyelashes and increased pigmentation of extra- and intraocular structures. A careful lifetime evaluation of these patients is recommended. Systemic side-effects are rare, but may occur.

Topics: Dose-Response Relationship, Drug; Eyelashes; Eyelid Diseases; Glaucoma; Hyperpigmentation; Hypertrichosis; Latanoprost; Macular Edema; Prostaglandins F, Synthetic; Risk Factors; Uveitis

Topics: Aged; Antihypertensive Agents; Female; Glaucoma, Open-Angle; Humans; Hyperpigmentation; Latanoprost; Ophthalmic Solutions; Prostaglandins F, Synthetic; Skin Pigmentation

Latanoprost, the active principle of Xalatan eye drops, is a prostaglandin F2alpha analogue in widespread use for the treatment of glaucoma. During chronic treatment with the drug, an increased pigmentation of the iris was observed in both primates and man. To gain an insight into the nature of this effect, we analyzed the stroma of the irides of cynomolgus monkeys subjected to 25-38 weeks of treatment. A highly sensitive procedure, based on chemical degradation by alkaline hydrogen peroxide oxidation, or hydriodic acid hydrolysis, was developed, which allowed eumelanin and pheomelanin analysis of a single iris at a time. Untreated monkey irides were found to be essentially pheomelanic, providing further support to the recently reported occurrence of these pigments in human irides. In the Latanoprost-treated eyes, the amount of eumelanin increased from three to sevenfold, while the variation of pheomelanin did not exceed 25%. The increase in eumelanin/pheomelanin ratio in the treated eyes, as compared with the contralateral control eyes, varied from three to fivefold, and the change was statistically significant (P < 0.01; t-test). Based on the results of parallel studies, showing that Latanoprost does not induce proliferation of iridial melanocytes, and that the other pigmented layers of the iris which do not contain melanocytes are not affected by the drug, it can be concluded that the observed effect is a result of a direct interaction with the melanogenic mechanism. This probably involves activation of tyrosinase, as suggested, to account for the stimulation of melanin synthesis by related compounds, including natural prostaglandins.

Topics: Administration, Topical; Animals; Antihypertensive Agents; Female; Hyperpigmentation; Iris; Iris Diseases; Latanoprost; Macaca fascicularis; Melanins; Melanocytes; Monophenol Monooxygenase; Ophthalmic Solutions; Prostaglandins F, Synthetic

To determine the role of sympathetic innervation and the effect of topical prostaglandin therapy on iris color in pigmented rabbits.. Twelve Dutch-belted rabbits underwent unilateral superior cervical ganglionectomy (SCGx) at age 1 to 3 months. A second group of 11 rabbits underwent bilateral SCGx at age 1 month and were treated once or twice daily for 6 to 9 months with 1 drop (about 20 microL) of latanoprost, 0.005%, to one eye and its vehicle to the contralateral eye. Standardized color photographs of the iris of each eye were taken at 1- to 2-month intervals for 6 to 10 months and evaluated by 4 to 6 observers in a masked fashion.. At 8 to 10 months after unilateral SCGx, 11 of 12 rabbits showed definite heterochromia, with the lighter-colored iris on the SCGx side. Of the 11 rabbits that underwent bilateral SCGx and unilateral latanoprost treatment, 9 showed heterochromia at 6 to 9 months, with the darker-colored iris on the latanoprost-treated side.. These results demonstrate that sympathetic innervation is required for age-related, physiologic darkening of iris color in rabbits, that prostaglandins may compensate for sympathetic denervation to produce darkening in SCGx eyes, and that this model may be useful to study prostaglandin-induced iris color change.

Topics: Administration, Topical; Animals; Eye Color; Female; Ganglia, Sympathetic; Ganglionectomy; Hyperpigmentation; Iris; Latanoprost; Models, Biological; Ophthalmic Solutions; Photography; Prostaglandins F, Synthetic; Rabbits

Topics: Administration, Topical; Aged; Eyelashes; Female; Glaucoma, Open-Angle; Hair Diseases; Humans; Hyperpigmentation; Intraocular Pressure; Latanoprost; Ophthalmic Solutions; Prostaglandins F, Synthetic