Ocular Surface Changes in Prostaglandin Analogue-Treated Patients

Abstract

Glaucoma is the second leading cause of blindness globally. Reducing intraocular pressure (IOP) has been acknowledged to be the main therapy for glaucoma. Prostaglandin analogues (PGAs) have become the first-line therapy for patients with glaucoma due to their powerful efficacy for lowering (IOP). However, usage of PGAs can also cause several notable side effects, including the changes in ocular surface. The relationship between PGAs and ocular surface changes is complicated and still remains unclear. In the present review, we summarize the recent studies of the effects of PGAs on ocular changes as well as the possible mechanisms that might provide new considerations during clinical medication.

A Narrative Review of Ocular Surface Disease Related to Anti-Glaucomatous Medications

“…Currently, there are six main kinds of topical drugs commonly used for clinical treatment of glaucoma, namely b-adrenergic blockers, prostaglandin analogues (PGAs), a-adrenergic agonists, carbonic anhydrase inhibitors (CAIs), cholinergic agonists, and Rho kinase inhibitors. A number of studies have shown that these compounds can reduce the viability of corneal epithelial cells at clinically relevant concentration, but will not destroy the stability of the cell membrane [9][10][11]. The long-term treatment cycle of glaucoma and combination with other drugs make the risk of OSD increase substantially.…”

Once-daily Preservative-free Topical Anti-glaucomatous Monotherapy – A Better Approach?

“…Early hyperaemia due to the active agent in prostaglandin analogue therapy is particularly marked in the first few days of administration but tends to reduce thereafter. 27…”

Efficacy of Nonpreserved Sodium Hyaluronate Artificial Tears in Dry Eye Disease Patients Treated with Prostaglandin Analogs for Primary Open-Angle Glaucoma: A Prospective, Nonrandomized, Open-Label Pilot Study

“…Many causes underlie the occurrence of DED. Te most common are the use of contact lenses, refractive laser cataract surgery, and the use of topical formulations containing preservatives and prostaglandin (PG) analogs for glaucoma and ocular hypertension [17,18]. Recent studies suggest that the use of topical formulations containing benzalkonium chloride (BAK) as a preservative may have adverse efects on the ocular surface [19].…”

“…Instead, PG analogs have become the frst-line therapy for treating patients with glaucoma due to their efcacy in lowering intraocular pressure (IOP) [18]. While reducing IOP, PG analogs are associated with ocular side efects, such as a prominent feature of ocular irritation associated with dry eye disease and an increase in conjunctival hyperaemia [23].…”

“…While reducing IOP, PG analogs are associated with ocular side efects, such as a prominent feature of ocular irritation associated with dry eye disease and an increase in conjunctival hyperaemia [23]. A recent meta-analysis of glaucoma patients showed that the risk of conjunctival hyperaemia increases in patients treated with PG analogs compared to patients treated with other classes of drugs [18,24]. Conjunctival hyperaemia is thought to be caused by nitric oxide-mediated vasodilation in the conjunctiva.…”