latanoprost and Uveitis--Anterior

To compare the efficacy and safety of latanoprost against a fixed combination of dorzolamide and timolol in eyes with elevated intraocular pressure (IOP) or glaucoma and anterior or intermediate uveitis.. Fifty-eight patients with anterior or intermediate uveitis and elevated IOP or glaucoma presented or followed up in the Ocular Inflammation and Immunology Service of General Hospital of Athens were randomly assigned to receive treatment either with latanoprost (30) or with dorzolamide/timolol (28). The main outcome measures were inflammatory relapses and IOP response to treatment.. Ten patients (34%) in the latanoprost group and sixteen patients (57%) in the dorzolamide/timolol group experienced relapses of anterior uveitis (p = 0.93). There was no statistical difference between the two groups in respect of inflammatory relapses (p = 0.21). Twenty-one patients were followed up before starting latanoprost. The number of recurrences of anterior uveitis per patient per year before treatment with latanoprost was 0.82 +/- 1.2. The rate of relapses per patient per year after starting latanoprost was 0.39 +/-0.7 for these patients (p = 0.038). After 1 year of treatment, intraocular pressure was dropped from 27.8 +/- 8.4 mmHg to 18.6 +/- 5.3 mmHg (p < 0.001) in the latanoprost group and from 28.2 +/-8.1 mmHg to 22.6 +/-10.1 mmHg (p < 0.001) in the dorzolamide/timolol group. Four patients during treatment with latanoprost and five patients during treatment with dorzolamide/timolol developed macular edema.. Latanoprost is safe and equally effective to a fixed combination of dorzolamide and timolol in the treatment of uveitic glaucoma.

Topics: Adult; Antihypertensive Agents; Drug Combinations; Female; Follow-Up Studies; Glaucoma; Gonioscopy; Humans; Intraocular Pressure; Latanoprost; Male; Ocular Hypertension; Prostaglandins F, Synthetic; Recurrence; Sulfonamides; Thiophenes; Timolol; Tonometry, Ocular; Treatment Outcome; Uveitis, Anterior; Uveitis, Intermediate; Visual Acuity

To compare 90 degrees , 180 degrees , and 360 degrees selective laser trabeculoplasty (SLT, 532 nm Nd:YAG laser) with latanoprost 0.005% for the control of intraocular pressure (IOP) in ocular hypertension (OHT) and open angle glaucoma (OAG).. A prospective, randomised clinical trial in the Department of Ophthalmology, St Thomas's Hospital, London, and Clayton Eye Centre, Wakefield, West Yorkshire. 167 patients (167 eyes) with either OHT or OAG were randomised to receive 90 degrees , 180 degrees , and 360 degrees SLT or latanoprost 0.005% at night and were evaluated at 1 hour, 1 day, 1 week and 1, 3, 6, and 12 months.. The mean follow up was 10.3 months (range 1--12 months). Early, transient, complications such as postoperative ocular pain, uveitis, and 1 hour IOP spike occurred in a number of eyes after SLT, with pain being reported more frequently after 360 degrees than 90 degrees treatments (p>0.001). Success rates defined in terms of both a 20% or more and a 30% or more IOP reduction from baseline measurements with no additional antiglaucomatous interventions were better with latanoprost than 90 degrees (p<0.001) and 180 degrees SLT (p<0.02) treatments. Differences in success rates between latanoprost and 360 degrees SLT did not reach statistical significance (p<0.5). Success rates were greater with 180 degrees and 360 degrees compared to 90 degrees SLT (p<0.05). With 360 degrees SLT, 82% of eyes achieved a >20% IOP reduction and 59% a >30% reduction from baseline. Although success rates were better with 360 degrees than 180 degrees SLT treatments, differences did not reach statistical significance. There were no differences with regard to age, sex, race, pretreatment IOP, OHT versus OAG, laser power settings, and total laser energy delivered between eyes which responded, in terms of a >20% and a >30% IOP reduction, and those that did not respond with 180 degrees and 360 degrees SLT treatments.. Success rates were higher with latanoprost 0.005% at night than with 90 degrees and 180 degrees SLT treatments. 90 degrees SLT is generally not effective. 360 degrees SLT appears to be an effective treatment with approximately 60% of eyes achieving an IOP reduction of 30% or more. Transient anterior uveitis with associated ocular discomfort is not unusual in the first few days after SLT. Late complications causing ocular morbidity after SLT were not encountered.

Topics: Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Female; Glaucoma, Open-Angle; Humans; Laser Therapy; Latanoprost; Male; Middle Aged; Ocular Hypertension; Prospective Studies; Prostaglandins F, Synthetic; Trabeculectomy; Uveitis, Anterior

The case concerns an 81-year-old woman on treatment with a topical fixed combination of timolol and brimonidine who was diagnosed in the Emergency Department with acute anterior granulomatous hypertensive uveitis. The patient responded favourably to the withdrawal of the eye drops without showing any subsequent relapse.. Uveitis due to brimonidine is a rare adverse effect, but it must be known. Once the diagnosis is suspected, the effective treatment is the withdrawal of brimonidine, with or without the addition of topical corticosteroids to control inflammation depending on the severity of the condition. It is a process with an excellent prognosis.

Topics: Acute Disease; Adrenergic alpha-2 Receptor Agonists; Aged, 80 and over; Brimonidine Tartrate; Conjunctivitis, Allergic; Cyclopentolate; Drug Therapy, Combination; Epithelium, Corneal; Female; Glaucoma, Open-Angle; Granuloma; Humans; Latanoprost; Lubricant Eye Drops; Ocular Hypertension; Ophthalmic Solutions; Prednisolone; Sulfonamides; Thiophenes; Timolol; Uveitis, Anterior

Topics: Antihypertensive Agents; Drug Combinations; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Prostaglandins F, Synthetic; Timolol; Uveitis, Anterior

The aim of this study was to report a case of severe bilateral fibrinous anterior uveitis following pamidronate therapy in a patient on latanoprost.. This study is presented as an interventional case report.. Clinical examination showed bilateral severe fibrinous uveitis following an intravenous infusion of disodium pamidronate. Ocular signs and symptoms responded to stopping latanoprost and treatment with oral prednisolone (60 mg) and hourly topical prednisolone acetate 1%. The reintroduction of latanoprost resulted in a recurrence, which was stopped with subsequent improvement.. Mild anterior uveitis is an unfamiliar adverse effect of pamidronate therapy. However, severe fibrinous uveitis has not been previously described. This may be due to the compounding effect of latanoprost. This case highlights the importance of history taking and awareness of the otherwise uncommon side effect of this commonly prescribed medication.

Topics: Acute Disease; Administration, Topical; Aged, 80 and over; Anti-Inflammatory Agents; Bone Density Conservation Agents; Diphosphonates; Drug Interactions; Female; Fibrin; Glaucoma, Open-Angle; Humans; Infusions, Intravenous; Latanoprost; Osteoporosis, Postmenopausal; Pamidronate; Prednisolone; Prostaglandins F, Synthetic; Recurrence; Uveitis, Anterior

Use of a prostaglandin analog in cataract surgery can cause cystoid macular edema in the pseudophakic patient, but this is a rare complication that resolves when treatment is stopped. However, in the surgical context, this type of eye drop should not be prescribed as first-line treatment and in any case it should be associated with nonsteroidal anti-inflammatory agents.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Cataract Extraction; Humans; Intraocular Pressure; Latanoprost; Macular Edema; Postoperative Complications; Prospective Studies; Prostaglandins F, Synthetic; Prostaglandins, Synthetic; Pseudophakia; Risk Factors; Uveitis, Anterior

The purpose of this study was to report paradoxical reaction on the intraocular pressure after treatment with latanoprost in 3 cases of uveitic glaucoma. Serial clinical examinations of intraocular pressure by means of daily tonometric curves were performed in three patients with uveitic glaucoma before and after the beginning of latanoprost therapy. All measurements were performed by two doctors, but every patient's IOP was always measured by the same doctor. Adverse reactions, such as increased intraocular pressure and recurrence of inflammation, were noted to occur 7 to 16 days after rechallenging with topical latanoprost therapy for glaucoma in patients with history of uveitic glaucoma. The conclusion indicates that clinicians should be alerted to these possible complications of topical latanoprost therapy in uveitic glaucoma.

Topics: Antihypertensive Agents; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Prostaglandins F, Synthetic; Tonometry, Ocular; Uveitis, Anterior

Topics: Aged; Antihypertensive Agents; Female; Glaucoma, Open-Angle; Hair Diseases; Humans; Latanoprost; Prostaglandins F, Synthetic; Uveitis, Anterior

To describe presumed activation of herpetic keratouveitis after argon laser peripheral iridotomy.. Case report.. A 68-year-old man developed chronic, unilateral, anterior uveitis associated with decreased corneal sensation, focal keratitis, and increased intraocular pressure after argon laser peripheral iridotomy. Treatment with oral acyclovir and discontinuation of topical latanoprost resulted in prompt and continued control of both the intraocular inflammation and pressure.. Herpetic keratouveitis may occur after argon laser iridotomy, and it should be considered when postoperative inflammation persists despite appropriate use of topical corticosteroids, particularly in patients with a history of herpetic eye disease.

Topics: Acyclovir; Aged; Antiviral Agents; Chronic Disease; Glaucoma; Herpesvirus 1, Human; Humans; Intraocular Pressure; Iris; Keratitis, Herpetic; Laser Therapy; Latanoprost; Male; Prostaglandins F, Synthetic; Uveitis, Anterior; Virus Activation

To evaluate the association of latanoprost with anterior chamber uveitis in glaucoma patients.. We retrospectively reviewed 527 charts in latanoprost treated patients with: no prior uveitis (Group 1); prior uveitis but were inactive at the time of the study (Group 2); and active uveitis (Group 3).. In Group 1 five (1.0%) of 505 patients developed uveitis after beginning latanoprost. The uveitis was trace to 1+ cell in severity and delayed in onset 99.8+/-73.9 days In Group 2 three of 13 (23.1%) patients developed delayed uveitis (trace to 1+ cell). In Group 3 zero of nine (0%) patients had worsened inflammation and the intraocular pressure remained unchanged (22.8+/-7.8 mmHg to 22.0+/-7.3 mmHg) after beginning latanoprost (p=0.38).. In patients without a prior history a mild delayed uveitis with latanoprost treatment may develop rarely. In patients with a uveitis history, a mild delayed exacerbation potentially may occur and the intraocular pressure may not be decreased in active uveitis.

Topics: Aged; Anterior Eye Segment; Female; Glaucoma, Open-Angle; Humans; Incidence; Intraocular Pressure; Latanoprost; Male; Ocular Hypertension; Ophthalmic Solutions; Prostaglandins F, Synthetic; Retrospective Studies; Texas; Uveitis, Anterior

This study aimed to investigate the incidence of cystoid macular edema and anterior uveitis associated with the use of latanoprost.. A retrospective review of patients treated with latanoprost in the authors' practice between September 1, 1996, and August 1, 1997, was performed.. Ninety-four patients and 163 eyes were studied.. Patients presenting with signs and symptoms of ocular inflammation while receiving latanoprost were noted, and their response to the discontinuation of the drug was recorded.. The presence and degree of anterior uveitis and cystoid macular edema were measured.. Six (6.4%) of 94 patients (8 [4.9%] of 163 eyes) had anterior uveitis develop, and 2 (2.1%) of 94 patients (2 [1.2%] of 163 eyes) had cystoid macular edema develop while being treated with latanoprost.. Although latanoprost is an effective ocular-hypotensive agent, the authors' experience with the drug has shown a significant incidence of anterior uveitis and cystoid macular edema. To the authors' knowledge, this is the first study to report the incidence of both cystoid macular edema and anterior uveitis associated with latanoprost therapy. Treating physicians should be aware of these potential complicating side effects of latanoprost.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Exfoliation Syndrome; Female; Fluorescein Angiography; Fundus Oculi; Glaucoma, Open-Angle; Humans; Incidence; Latanoprost; Macular Edema; Male; Middle Aged; Prostaglandins F, Synthetic; Retrospective Studies; Uveitis, Anterior

To report the association of anterior uveitis with the use of latanoprost.. We studied four patients with complicated open-angle glaucoma who had anterior uveitis associated with the use of latanoprost. The uveitis was unilateral and occurred only in the eye receiving latanoprost in three patients. In one patient, latanoprost was used in both eyes, and the uveitis was bilateral. Four of five eyes had a history of prior inflammation and/or prior incisional surgery. All patients were rechallenged with the drug.. The uveitis improved after cessation of latanoprost with or without topical corticosteroids. It recurred after rechallenging with latanoprost in all eyes.. There is a possible association between latanoprost and anterior uveitis. Topical prostaglandin analogs may be relatively contraindicated in patients with a history of uveitis or prior ocular surgery. This association may also be possible in eyes that have not had previous uveitis or incisional surgery.

Topics: Administration, Topical; Adult; Aged; Female; Glaucoma, Open-Angle; Glucocorticoids; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ophthalmic Solutions; Prednisolone; Prostaglandins F, Synthetic; Uveitis, Anterior; Visual Acuity

Topics: Glaucoma; Humans; Incidence; Latanoprost; Macular Edema; Prevalence; Prostaglandins F, Synthetic; Statistics as Topic; Uveitis, Anterior

Topics: Glaucoma; Humans; Latanoprost; Macular Edema; Prostaglandins F, Synthetic; Risk Factors; Uveitis, Anterior

Topics: Aged; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Macular Edema; Male; Prostaglandins F, Synthetic; Uveitis, Anterior; Vision Disorders; Visual Acuity