Iridial pigmentation and eyelash change occurred at a high frequency in long-term treatment with latanoprost in Japanese glaucoma patients.

It is unlikely that topical latanoprost induces retinal disorders, such as cystoid macular edema, in glaucomatous eyes with a normally functioning blood-ocular barrier.

The incidence of iridial pigmentation by latanoprost ophthalmic solution in Japanese patients was higher than previously reported values in pigmented races.

Br J Ophthalmol 2003;87:956-959 Aim: To compare incidence of iridial pigmentation prospectively induced by long term treatment with latanoprost and isopropyl unoprostone (hereafter, unoprostone) in Japanese patients with glaucoma. Methods: 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. Results: 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. Conclusions: 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.

Purpose: The effectiveness of scanning laser polarimetry (by the nerve fibre analyser, NFA) and of optical coherence tomography (OCT) in estimating nerve fibre layer thickness (NFLT) and the correlations between NFLT and cup-to-disc (C/D) ratio or values of mean deviation (MD) from static visual field tests were compared using patients with glaucoma. Materials and Methods: Twenty-four eyes from 24 glaucoma patients were enrolled. The NFLT was measured along a circle with a diameter 1.5 times that of the optic disc around the optic disc. The averaged estimated NFLT of the circle or of each quadrantal NFLT (nasal, temporal, superior, inferior) was compared. Results: The co-variant indexes measured by the NFA were significantly smaller than those measured by OCT in both the averaged NFLT (p = 0.0002) and in each quadrantal NFLT (p < 0.05). The C/D ratio was significantly correlated with the averaged NFLT when measured by OCT (r = 0.425, p = 0.038), but not by the NFA (r = 0.179, p = 0.407). However, when measured by OCT, these values showed a significant correlation (r = 0.425, p = 0.039). Although both the OCT and NFA data showed significant correlations between NFLT and the MD (p = 0.0002 and p = 0.038, respectively), the OCT data showed a stronger correlation than did the NFA data (r = 0.677 and r = 0.422, respectively). The correlation between the averaged NFLTs obtained by NFA and OCT was not significant (r = 0.289, p = 0.172). Conclusion: OCT is thought to have an equal or better effectiveness for estimating NFLT, in spite of a lower reproducibility than that of the NFA.