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BACKGROUND: To investigate the frequency of PAP (prostaglandin-associated periorbitopathy) among bimatoprost, latanoprost and travoprost users. DESIGN: Retrospective observational case series. PARTICIPANTS: The study group included 105 patients who were using one of the drugs in one eye for more than one month, and the other eye was used as a control. MAIN OUTCOME MEASURES: The frequency of PAP. METHODS: Special care was taken to detect five PAP findings. Hertel exophthalmometry measurements and color pictures of the periocular area were taken. RESULTS: 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 93.3% in the bimatoprost group, 41.4% 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, 15.7% 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 the presence of both) was higher in the latanoprost group (62%) than in the travoprost (35.7%) and bimatoprost (7.1%) groups. CONCLUSIONS: PAP is as common as other adverse effects when careful examinations are performed and is more frequent and more severe in bimatoprost users. The loss of the periorbital fat pad is the first sign to occur during the evolution of PAP, especially in older patients.
Gulhane Military Academy of Medicine, Department of Ophthalmology, Ankara, Turkey.
Full article11.4 Prostaglandins (Part of: 11 Medical treatment)