Periorbital Changes Associated With Topical Bimatoprost

Abstract

Physicians and patients should be aware of the potential of bimatoprost 0.03% to produce periorbital changes.

1258 In Vitro study of Anti-adipogenic Profile of Latanoprost, Travoprost, Bimatoprost and Tafluprost in Human Orbital Preadiopocytes

“…14,15 Periorbital fat atrophy was also demonstrated on MRI scaning. 16 It was, therefore, inferred that the common pathophysiologic mechanism of these periocular changes was atrophy of orbital fat.…”

“…However, there are recent reports of deepening of the eyelid superior sulcus after long-term instillation of topical prostaglandin analogs that was recovered by discontinuation of the topical prostaglandin therapy, [11][12][13][14][15][16][17][18][19][20] and some of these patients have shown enophthalmos combined with superior sulcus deepening. [14][15][16]20 This recently recognized complication causes a disparity in the appearance of the eyelids and could be a reason for stopping glaucoma drug therapy.…”

Changes of orbital connective tissue after bimatoprost injection. Experimental study in rats

“…The objective of the analysis of these groups was to observe the disappearance of changes in the orbital connective tissue after discontinuation of bimatoprost 0.03%, and the time required for this reversal. Some authors report the improvement of the signs after the discontinuation of medication (15) . The animals on G7 (group control) were submitted to unilateral retrobulbar injection (right orbit) of saline solution every week for 4 weeks in order to exclude possible changes of orbital changes triggered by trauma orbit trauma-related inflammatory processes (retrocular injection).…”

“…Peplinski and Smith reported unilateral and ipsilateral deep upper eyelid creases (13) . Filippopoulos et al described upper deep eyelid creases, apparent enophthalmos and attenuation of dermatochalasis (15) . Based mainly on the pharmacological properties of bimatoprost, the hypothesis of these eyelid and orbital changes were resulting from the reduction of preaponeurotic and orbital fat was created (13,16,17) .…”

“…The exposure period was thus defined, as the literature reports that the onset of adverse effects in glaucoma patients is observed mainly 3 months after the start of the use of bimatoprost 0.03% eyedrops (13)(14)(15) . The unilateral retrobulbar injection allows determining if the adverse effects are local or systemic.…”