PURPOSE: To investigate changes in the interpupillary distance (IPD) after continual instillation of topical prostaglandin analogues (PGAs) in glaucoma patients as an objective indicator of prostaglandin-associated periorbitopathy (PAP). DESIGN: Retrospective, comparative case series. METHODS: SETTING: Institutional. PATIENTS: Patients (n=152) with glaucoma. Inclusion criteria were visual acuities exceeding 10/20 bilaterally and no intraocular surgery during observation. INTERVENTION/OBSERVATION PROCEDURES: First-time bilateral instillation of bimatoprost, travoprost, latanoprost, or tafluprost and IPDs measured by automatic refractometry. IPDs, intraocular pressures (IOPs), and refractive errors were measured before and after continual drug administration (treatment, 2-24 months). MAIN OUTCOME MEASURES: Post-treatment changes in IPDs. Sixty-one untreated patients served as controls. RESULTS: The IPDs shortened significantly (P<0.001) post-treatment (-0.80±2.1 mm); the controls remained unchanged (0.05±0.96 mm, P=0.69). The IPD change after bimatoprost instillation (-2.20±0.97 mm) was significantly (P<0.001) greater than with other PGAs (-0.65±2.09 mm). The IOPs decreased significantly (P<0.001) (-3.7±4.3 mmHg); the refractive errors did not change significantly (P<0.099) (-0.07±0.69 diopter) post-treatment. The percentages of subjects with 2-mm or greater decreases in IPD after bimatoprost, travoprost, latanoprost, or tafluprost, respectively, were 85.7%, 20.0%, 18.2%, and 17.2% and with 3-mm or greater decreases in IPD 35.7%, 12.0%, 14.5%, and 12.1%. The specificities were 93.4% and 100% in the control group, respectively, with IPD threshold changes of 2 mm or more and 3 mm or more. CONCLUSION: The IPD decreased significantly after topical PGAs within 24 months. The effect was significantly greater with bimatoprost than with other PGAs. The non-invasive, immediate automatic refractometry measurement might be an objective numerical indicator of PAP.
Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi 329-0431, Japan; Japan.Full article
11.4 Prostaglandins (Part of: 11 Medical treatment)