travoprost and Iris-Diseases

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 investigate the topical use of travoprost [Trademark: Travatan (Alcon laboratories Inc, TX)] and the incidence of iridial pigmentation change in the brown irises of Chinese eyes.. Prospective, masked, observational study. Enrolled in the study were 37 Chinese subjects (73 eyes) with primary open-angle glaucoma who were being treated for the first time with travoprost eye drops (patient-group). Twenty-one Chinese volunteers with normal eyes (42 eyes) served as the control-group. To evaluate iris pigmentation, photographs were taken of the control-group's irises using a slit-lamp biomicroscope with attached digital camera. Before the start of travoprost treatment and 3 months after the start of travoprost treatment, photographs of the irises of the patient-group were taken using the same photographic methods. Five glaucoma specialists independently read the series of photographs to determine if there was an increase in iris pigmentation. Three of the 5 observers had to be in agreement that there was an increase from the baseline. "Picture Color Analyzer" computer software was also used to calculate the color value of each iris picture.. Observation with eyes: Twenty-six eyes (35.6%) in the patient-group developed an increase in iris pigmentation compared with zero subjects (0%) in the control-group (P=0.000, chi(2) test). Results with Picture Color Analyzer software: On the basis of the threshold value that was obtained from the control-group, 22 eyes (30.1%, n=73) in the patient-group were shown to have developed an increase in iris pigmentation.. Contrary to the previous studies that noted that the percentage of iris hyperpigmentation caused by travoprost in homochromic brown eyes was very low, our study showed that 35.6% iris hyperpigmentation did occur, which is a considerably higher percentage than that reported in whites.

Topics: Adolescent; Adult; Aged; Antihypertensive Agents; China; Cloprostenol; Dose-Response Relationship, Drug; Double-Blind Method; Eye Color; Female; Follow-Up Studies; Glaucoma, Open-Angle; Humans; Incidence; Iris; Iris Diseases; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Prognosis; Prospective Studies; Travoprost; Young Adult

A case of unilateral iridis hyperpigmentation and uveitis due to travoprost is presented.. Anterior uveitis is a rare side-effect of travoprost. In this case, heterochromic iris was also presented, which led us to the wrong diagnosis of a Fuchs heterochromic iridocyclitis. The differencial diagnosis along with the associated literature is discussed.

Topics: Aged, 80 and over; Antihypertensive Agents; Cloprostenol; Humans; Iris Diseases; Male; Pigmentation Disorders; Travoprost; Uveitis