uf-021 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 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

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