Prostaglandin analogs may cause periorbitopathy.
Study 1
Doran et al (2012) described an unexpected side effect of prostaglandin analogues, prostaglandin associated periorbotopathy (PAP). The characteristic features are: upper lid ptosis, deepening of the upper lid sulcus, involution of dermatochalasis, periorbital fat atrophy, mild enophthalmos, inferior scleral show, increased prominence of lid vessels, tight eyelids «Doran M, Berke SJ, Pasquale LR. What clinicians ne...»1, «Filippopoulos T, Paula JS, Torun N ym. Periorbital...»2, «Peplinski LS, Albiani Smith K. Deepening of lid su...»3, «Tappeiner C, Perren B, Iliev ME ym. [Orbital fat a...»4, «Jayaprakasam A, Ghazi-Nouri S. Periorbital fat atr...»5, «Park J, Cho HK, Moon JI. Changes to upper eyelid o...»6 .
Study 2
Kucukevcilioglu et al. investigated prostaglandin associated periorbitopathy (PAP) in 105 patiens using bimatoprost, latanoprost or travoprost for more than one month. The other eye was used as a control. Statistically significant differences were found among the groups regarding the presence of all PAP findings (p<0.05). Periorbital fat loss was the most frequent finding and was observed in nearly all PAP patients except those who were relatively young. The overall frequency of PAP was 93% in the bimatoprost group, 41% in the latanoprost group, and 70% in the travoprost group. The frequency of deepening of the upper lid sulcus was 80% in the bimatoprost group, 16% in the latanoprost group, and 45% in the travoprost group. The frequency of milder changes (the presence of either only periorbital fat loss, or dermatochalasis involution, or both) was higher in the latanoprost group (62%) than in the travoprost (36%) and bimatoprost (7%) groups «Kucukevcilioglu M, Bayer A, Uysal Y ym. Prostaglan...»7.
Study 3
Sakata et al. investigated deepening of the upper eyelid sulcus (DUES), one symptom of prostaglandin-associated periorbitopathy. The open-label prospective study investigated the incidence and factors associated with DUES in Japanese glaucoma patients initially treated with benzalkonium chloride (BAK)-preserved tafluprost. Tafluprost was instilled in one eye. Facial photographs and subjective reports of DUES were obtained at intervals over 6 months. 43 eyes of 43 glaucoma patients (24 men and 19 women) were evaluated. Mean IOP before treatment was 16.6 ± 2.7 and after treatment, 14.1 ± 2.3 mmHg (P < 0.001). The objective rate of DUES was 9% (4/43) at 2 months, 14% (6/43) at 4 months and 14% (6/43) at 6 months. During this period, only one patient self-reported DUES. No significant association was found between DUES occurrence and other systemic or ocular factors «Sakata R, Shirato S, Miyata K ym. Incidence of dee...»8.
Study 4
Choi et al. investigated in vitro the potential mechanisms by which topical prostaglandin analogs could induce orbital fat volume reduction and cause deep superior sulcus syndrome. Human orbital adipose precursors were treated in vitro for 24 h (day 1) with prostaglandin F2α (PGF2α), latanoprost, travoprost, bimatoprost, and tafluprost in their commercial formulations (1:100 dilution). Latanoprost, travoprost, bimatoprost, and tafluprost inhibited human preadipocyte differentiation and intracellular lipid accumulation. Morphologic and metabolic changes in orbital adipocytes caused by PGF2α analogs may be a possible pathophysiologic explanation of superior eyelid deepening in patients with glaucoma. «Choi HY, Lee JE, Lee JW ym. In vitro study of anti...»9