Prostaglandin analogue drops for the treatment of soft tissue expansion and exophthalmos in patients with inactive thyroid eye disease

Eiger-Moscovich, Maya; Stiebel‐Kalish, Hadas; Yassur, Iftach; Barash, David; Gaton, Dan D.; Avisar, Inbal

doi:10.1016/j.jcjo.2018.09.003

Cited by 6 publications

(2 citation statements)

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“…PA drops have been safely used in patients with inactive thyroid eye disease to induce fat atrophy and reduce thyroid orbitopathy associated proptosis. 9 Bimatoprost has in fact been shown to decrease cell migration and adipose differentiation in patients with thyroid orbitopathy. 10 From the success seen in our patient, we postulate that in the setting of raised IOP and pathological proptosis, a PA could be used as the preferred therapeutic choice to control IOP and to reduce the effects of proptosis.…”

Section: Discussionmentioning

confidence: 99%

“…The effects of PAP in providing aesthetic rehabilitation may be more strikingly beneficial in patients with unilateral proptosis. Eiger-Moscovich et al 9 have piloted the use of PA in thyroid patients with periocular soft tissue expansion without IOP rise. The study, which was in press at the time of writing this article, found subjective improvement in facial appearance of thyroid patients; however, the study was statistically underpowered to show positive results.…”

Section: Discussionmentioning

confidence: 99%

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Prostaglandin analogues: A double-edged sword in orbital glaucoma disease management

Joganathan

Cannon

Mercieca

2020

European Journal of Ophthalmology

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Introduction: The authors describe benefits of the recognised adverse effects of prostaglandin analogues on periocular structures in patients with unilateral proptosis and intraocular pressure rise. This case points to intentional consideration of prostaglandin analogue therapy in this selected cohort of patients with secondary ocular hypertension and proptosis. Case description: A 70-year-old gentleman who presented with a 1-week history of a red and painful right eye associated with tortuous and dilated episcleral blood vessels. Visual acuity was unaffected. A diagnosis of idiopathic orbital inflammatory disease was made by extraocular muscle biopsy. Two weeks later, the patient presented with worsening pain, reduced vision and raised intraocular pressure. The secondary ocular hypertension was successfully treated with topical preserved eye drops, including latanoprost, a prostaglandin analogue. Over 6 months, the patient developed drop intolerance and punctate keratopathy leading to therapy non-adherence. Interestingly, the patient reported improvement in periocular appearance related to prostaglandin-associated periorbitopathy. Ocular surface disease and intraocular pressures were subsequently managed with preservative-free eye drops. Conclusion: Secondary ocular hypertension is not an uncommon consequence of orbital disease. Prostaglandin analogue can act as a double-edged sword in the management of raised intraocular pressure by reducing eye pressure at the cost of developing adverse effects of prostaglandin-associated periorbitopathy. These adverse effects however can be beneficial in the aesthetic rehabilitation of proptosis and associated exposure keratopathy in patients with unilateral orbital disease and probably should be sought as first line treatment in those with proptosis and raised intraocular pressure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%