Decreased orbital fat and enophthalmos due to bimatoprost: Quantitative analysis using magnetic resonance imaging

Higashiyama, Tomoaki; Minamikawa, Takayuki; Kakinoki, Masashi; Sawada, Osamu; Ohji, Masahito

doi:10.1371/journal.pone.0214065

Cited by 8 publications

(10 citation statements)

References 31 publications

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“…11,45,46 One retrospective study has suggested that enophthalmos may occur in eyes unilaterally treated with latanoprost. 47 However, enophthalmos is not typically reported in patients with POAG and would not have been significant in the small unilateral treatment study by Higashiyama et al, 12 except with the inclusion of one marked outlier case.…”

Section: Discussionmentioning

confidence: 98%

“…However, since Asian subjects with and without POAG had smaller OV than non-Asians, the possibility of a relationship between orbital size and POAG at normal IOP warrants further investigation. The Higashiyama et al 12 study used MRI to compare OFV in nine patients treated monocularly with brimatoprost for secondary glaucomas for at least 11 months. These authors reported mean OFV to be significantly smaller in the treated than nontreated eye.…”

Section: Discussionmentioning

confidence: 99%

“…However, the modest 0.04 level of statistical significance for this small study was driven by a single patient who had an abnormally high OFV in the untreated fellow orbit. 12 The present study was motivated by recognition that adipogenesis is inhibited by PGAs through activation of the FP receptor, which may cause fat atrophy. 42,43 Common PGAs used today to reduce IOP include latanoprost, timolol, bimatoprost, travoprost, and tafluprost, as well as fixed combinations like latanoprost-timolol, bimatoprost-timolol, travoprost-timolol, and tafluprost-timolol.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, we sought to clarify the foregoing questions through high resolution, surface coil MRI of OFV and orbital dimensions in patients with POAG without abnormally elevated IOP who had been treated with topical PGA drugs. We aimed to extend the literature beyond the small number of previously-reported patients who were monocularly treated for secondary glaucoma 12 and to evaluate the anatomic compartments where the orbital fat resides.…”

mentioning

confidence: 99%

“… 7 , 10 , 11 Recently, Higashiyama et al used standard magnetic resonance imaging (MRI) to compare orbital fat volume (OFV) in nine patients treated monocularly with brimatoprost for various secondary glaucomas for at least 11 months, reporting mean OFV to be significantly smaller in the treated than nontreated eye. 12 There is no comparable study of the effects of PGAs in POAG without abnormally elevated IOP.…”

mentioning

confidence: 99%

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Orbital Fat Volume After Treatment with Topical Prostaglandin Agonists

Chen

Giaconi

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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Topical prostaglandin analogs (PGAs) are common treatment for primary openangle glaucoma (POAG) but reportedly may cause adnexal fat atrophy. We asked if patients with POAG treated with PGAs have abnormalities in orbital fat volume (OFV). METHODS. We studied 23 subjects with POAG who had never experienced intraocular pressure (IOP) exceeding 21 mm Hg and were treated long term with PGAs, in comparison with 21 age-matched controls. Orbital volume, non-fat orbital tissue volume, and OFV were measured using high-resolution magnetic resonance imaging. RESULTS. Subjects with POAG had been treated with PGAs for 39 ± 19 months (SD) and were all treated within the 4 months preceding study. In the region from trochlea to orbital apex, OFV in POAG was significantly less at 9.8 ± 1.9 mL than in the control subjects at 11.1 ± 1.3 mL (P = 0.019). However, between the globe-optic nerve junction (GONJ) and trochlea, OFV was similar in both groups. Width and cross sectional area of the bony orbit were significantly smaller in POAG than in controls (P < 0.0001). Posterior to the GONJ, the average orbital cross-sectional area was 68.2 mm 2 smaller, and the orbital width averaged 1.5 mm smaller throughout the orbit, in patients with POAG than in controls. CONCLUSIONS. Patients with POAG who have been treated with PGAs have lower overall OFV than controls, but OFV in the anterior orbit is similar in both groups. Lower overall OFV in POAG may be a primary association of this disorder with a horizontally narrower bony orbit, which may be a risk factor for POAG at nonelevated IOPs.

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