Latanoprost-Induced Prostaglandin-Associated Periorbitopathy

Abstract

Latanoprost can cause PAP, although it has a lower risk and longer latency of onset than those with bimatoprost and travoprost. Clinicians should be aware of this side effect and monitor for signs periodically. Chronic unilateral prostaglandin use may cause unfavorable asymmetry in the appearance of the periorbital area.

Incidence of deepening of the upper eyelid sulcus in prostaglandin-associated periorbitopathy with a latanoprost ophthalmic solution

“…3 Among these local side effects, prostaglandin-associated periorbitopathy (PAP), 4 which includes periorbital fat atrophy, deepening of the upper eyelid sulcus (DUES), ptosis, enophthalmos, and involution of dermatochalasis, has been reported after the use of prostaglandin F 2a and prostamide analogs. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] DUES, which has been closely monitored for several years, is the most prominent clinical feature of PAP. Since the first case report of bimatoprost (BIM)-induced DUES, 5 many cases induced by PGAs have been reported.…”

Unilateral Prostaglandin-Associated Periorbitopathy

“…[29][30][31] Since the initial report by Peplinski and Smith, many case series have assessed the effects of PGA use on the ocular adnexa, none of which produce consistent and reproducible orbital and adnexal measurements that fully quantify and qualify PAP. [15][16][17][18][19][20][21][22][23][24][25][26][27][28] Most of these studies were based on either patient or family member's complaints. Interestingly, only 27% of our subjects noticed changes in their eyelids since beginning PGA therapy, and only 15% of these were bothered by these alterations.…”

“…Since then there have been many case reports and series describing PAP. [15][16][17][18][19][20][21][22][23][24][25][26][27][28] These are small studies with varying clinical measurements and are based largely on patient complaints. The histopathologic mechanisms and manifestations of orbital lipolysis have, however, been objectively shown.…”

Periocular changes in topical bimatoprost and latanoprost use

“…The deepening of upper eyelid sulcus, blepharoptosis, involution of dermatochalasia, and flattening of lower eyelid bags were seen after a mean consumption time of 6 years (3 to 8 years). The researchers drew attention to the lower risk and longer latency of onset of these changes with latanoprost than with bimatoprost or travoprost (20). Cochran's test (with Bonferroni procedure); P < 0.008 is statistically significant; N, number; Mo, month.…”