latanoprost and Uveitis

Of the side effects of prostaglandin analogues (PGAs), uveitis and cystoid macular oedema (CME) have significant potential for vision loss based on postmarket reports. Caution has been advised due to concerns of macular oedema and uveitis. In this report, we researched and summarised the original data suggesting these effects and determined their incidence.. Preferred Reporting Items for Systematic review and Meta-Analyses guidelines were followed. Studies evaluating topical PGAs in patients with ocular hypertension or open angle glaucoma were included. MEDLINE, PubMed, EMBASE, CINAHL, Web of Science, Cochrane Library, LILACS and ClinicalTrials.gov were searched between 1946 and 2019. Experimental studies, animal studies and randomised studies with other intraocular pressure-lowering eye drops were excluded.. 214 studies (28 232 patients) met the inclusion criteria. Using prospective data, the incidence of uveitis and CME among PGA users were 62/28 232 (0.22%) and 25/28 232 (0.09%), respectively. A higher frequency of both uveitis and CME were found among latanoprost users compared with bimatoprost. There were 21 case studies reporting CME including 48 eyes in 43 patients. 47 of 48 eyes (97.9%) had previous incisional ocular surgery. 8 eyes were re-challenged, of which 7 (87.5%) recurred. 7 case studies reported uveitis in 15 eyes of 10 patients. 7 of 15 eyes (46.7%) were either pseudophakic or aphakic. 6 eyes were re-challenged, and all 6 (100%) recurred.. Cases of uveitis or CME revealed a confounding effect of ocular surgery, aphakia or subluxed intraocular lens. PGAs may be used in non-surgical patients without concern of causing CME or uveitis. The incidences of PGA-associated CME and uveitis are rare with limited prospective studies on the cause-effect relationship.

Topics: Administration, Ophthalmic; Bimatoprost; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Macular Edema; Ocular Hypertension; Ophthalmic Solutions; Prostaglandins, Synthetic; Uveitis

There is debate concerning whether the use of Latanoprost in early postoperative period of cataract surgery and in glaucoma patients with uveitis as it may aggravate the inflammation and results in macular edema (ME), because of blood-ocular barrier disruption. However, there is no solid evidence for disruption of blood-ocular barrier with Latanoprost and aggravation of uveitis or ME formation. Similar to pseudophakic ME, the imaging ME in cases claimed to be secondary to Latanoprost is greater than clinical ME, happens mostly in complicated surgeries, and the vast majority resolve within weeks to months with using a non-steroidal anti-inflammatory drug. The current literature suggests that Latanoprost can be used in patients with uveitis and early after cataract surgery with or without concomitant topical non-steroidal anti-inflammatory drugs that are currently used by many ophthalmologists as a preventive measure for ME even in non-glaucoma uncomplicated cataract surgeries.

Topics: Antihypertensive Agents; Humans; Inflammation; Latanoprost; Macular Edema; Uveitis

Two prostaglandin molecules have important physiological and pathophysiological role in the tissues of the eye. Prostaglandin F2 alpha takes part in mediating intraocular pressure, prostaglandin E2 is the mediator of inflammation. In case of increased intraocular pressure, latanoprost a derivative of prostaglandin F2 alpha can be applied. Numerous data are available on the favourable intraocular pressure lowering effect of latanoprost. It can be applied as a single hypotensive or it can be combined with eye-drops currently used in glaucoma. It exerts its therapeutic effect by increasing uveoscleral outflow. Inflammation in the eye can be diminished by nonsteroidal anti-inflammatory drugs similarly to inflammations in other tissues of the organism. Literature on nonsteroidal anti-inflammatory drugs is enormous. Molecules of different structures inhibit the synthesis of prostaglandins. Primarily they are useful anti-inflammatory agents, reduce intraocular pressure in secundary glaucoma, inhibit intraocular miosis and prevent development of cystoid macula oedema. Nonsteroidal anti-inflammatory drugs do not exert their effects on prostaglandins themselves, but inhibit their synthesis. Hence the use of both, latanoprost and nonsteroidal anti-inflammatory drugs simultaneously, improves safety of therapy in case of patients prone to uveitis.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Dinoprost; Dinoprostone; Eye; Humans; Intraocular Pressure; Latanoprost; Ocular Hypertension; Ocular Physiological Phenomena; Prostaglandins; Prostaglandins F, Synthetic; Uveitis

To evaluate the efficacy and safety of replacing current dual ocular hypotensive therapy with latanoprost 0.005% monotherapy in patients with open angle glaucoma.. This randomised, open label, parallel group, multinational study included 466 patients with open angle glaucoma currently on dual ocular hypotensive therapy, including a beta adrenergic receptor antagonist. Patients were assigned (1:3) to ongoing dual therapy or a switch to monotherapy with latanoprost 0.005% once daily for 6 months. Intraocular pressure (IOP) was measured at 10 am and 5 pm at baseline, month 3, and month 6. Groups were compared for differences in diurnal IOP change, IOP success rates (IOP < or =22 mm Hg with < or =15% increase from baseline), and clinical success rates (not requiring change in therapy).. Baseline mean diurnal IOP was 17.8 (SD 2.0) mm Hg in the latanoprost group and 17.6 (2.1) mm Hg in the dual therapy group. After 6 months, mean diurnal IOP was reduced by 0.26 (0.18) (SEM 1.4%) mm Hg (p=0.153) in the group switched to latanoprost and by 0.37 (0.25) (2.1%) mm Hg (p=0.138) in those continuing dual therapy (difference: 0.11 mm Hg; p=0.641). Success rates defined by IOP criteria were 83% for latanoprost and 89% for continued dual therapy (difference: 6%; p=0.122). Clinical success rates were 97% for latanoprost and 99% for dual therapy (difference: 2%; p=0.161). Ocular adverse events were reported by 23% of patients in both treatment groups.. Latanoprost monotherapy is a safe and effective alternative for many patients with open angle glaucoma requiring dual topical ocular hypotensive therapy for IOP control.

Topics: Adrenergic beta-Antagonists; Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Chi-Square Distribution; Drug Therapy, Combination; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Macular Edema; Male; Middle Aged; Prostaglandins F, Synthetic; Uveitis

To compare latanoprost/timolol (LT) versus travoprost/timolol (TT) fixed combinations for ocular hypertension (OHT) associated with uveitis.. Thirty-six patients (55 eyes) who were treated with LT (28 eyes) or TT (27 eyes) for OHT associated with uveitis were reviewed retrospectively. Intraocular pressure (IOP) and inflammation scores at the initiation of treatment and at the last visit during therapy were analyzed.. Although IOP was reduced significantly in both LT and TT groups, the reduction rate was significantly greater with TT group than with LT. The differences in the reduction of IOP between the groups remained significant when the cases were classified into inflammation-induced OHT and steroid-induced OHT. Inflammation score was not exacerbated by LT or TT treatment.. Both LT and TT are safe and effective for the treatment of OHT associated with uveitis and greater IOP reduction may be achieved by TT than by LT treatment.

Topics: Antihypertensive Agents; Drug Combinations; Female; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Prostaglandins F, Synthetic; Retrospective Studies; Timolol; Tonometry, Ocular; Travoprost; Treatment Outcome; Uveitis

A 41-year-old woman with acute OD pain and decreased visual acuity presented with anterior uveitis, an intraocular pressure of 56 mm Hg, an open angle, ipsilateral nerve fiber bundle visual field defects, and optic nerve edema. With control of intraocular pressure and uveitis, visual acuity improved to 20/25, visual field defects persisted, and optic disc pallor developed. She has remained stable over 23 months of follow-up. This case represents a concurrence of glaucomatocyclitic crisis (Posner-Schlossman syndrome, PSS) and nonarteritic ischemic optic neuropathy (NAION). Although this combination occurs rarely, patients with PSS and other risk factors for NAION, including an optic disc that lacks a physiologic cup, should be protected against NAION by prophylactic treatment with ocular antihypertensive medications.

Topics: Adult; Ciliary Body; Female; Glaucoma; Humans; Intraocular Pressure; Latanoprost; Optic Disk; Optic Neuropathy, Ischemic; Prostaglandins F, Synthetic; Syndrome; Uveitis; Visual Acuity; Visual Fields

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

The purpose of our study is to evaluate the effect of a single drop of latanoprost on the intraocular pressure and blood-aqueous barrier permeability in 8 patients with uveitis. The degree of inflammation was determined by the intensity of aqueous flare measured with a laser flare cell meter every 2 hours from 11:00 to 17:00 hours for 2 days. Intraocular pressure was measured at 11:00 and 17:00 hours with a Goldmann applanation tonometer on both days. Patients were given one drop of 0.005% latanoprost at 11:00 hours on day 2 and results were compared with day 1 when latanoprost was not administered. There was no significant difference in the intensity of aqueous flare or intraocular pressure between day 1 and day 2. A single drop of latanoprost had little effect on intraocular pressure and aqueous flare intensity in patients with uveitis.

Topics: Administration, Topical; Adult; Aged; Blood-Aqueous Barrier; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ophthalmic Solutions; Prospective Studies; Prostaglandins F, Synthetic; Sampling Studies; Severity of Illness Index; Tonometry, Ocular; Treatment Outcome; Uveitis

We examined the effects of prostaglandin analogues on the blood-aqueous barrier(BAB) permeability in rabbit eyes at an early phase of endotoxin-induced uveitis(EIU).. One drop of 0.005% latanoprost or 0.12% unoprostone were applied to rabbit eyes. Escherichia coli lipopolysaccharides were injected to induce uveitis. The changes in flare intensity in normal eyes and EIU eyes after application of eye drops were evaluated. The effect of cyclooxygenase inhibitor on the flare intensity changes caused by the application of unoprostone was also examined.. Flare intensity increased significantly after a single instillation of unoprostone, and the increase was not prevented by pretreatment with cyclooxygenase inhibitor. In eyes with EIU, unoprostone caused an additional increase of flare intensity to uveitis induced flare change. Latanoprost had no effects on BAB in eyes with normal and with uveitic conditions.. Latanoprost and unoprostone did not cause an excessive inflammatory reaction in rabbit eyes at an early phase of EIU.

Topics: Animals; Blood-Aqueous Barrier; Dinoprost; Female; Latanoprost; Male; Prostaglandins F, Synthetic; Rabbits; Uveitis