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Editors Selection IGR 22-3

Medical treatment: Latanoprost anterior chamber

Comment by Tec Kuan Paul Chew on:

15136 Short-term effects of latanoprost on anterior chamber depth in patients with glaucoma or ocular hypertension, Gutierrez-Ortiz C; Teus MA; Bolivar G, Investigative Ophthalmology and Visual Science, 2006; 47: 4856-4859

Find related abstracts

Prostaglandin F (2 alpha) analogues such as Latanoprost may cause a decrease in extracellular matrices. Gutierrez-Ortiz et al. (1238), in a prospective, non-randomized autocomparative trial, evaluated the effect of Latanoprost 0.005% on the anterior chamber depth (ACD) by A-mode ultrasonography, best corrected visual acuity (BCVA), lens thickness and anterior chamber dynamics in patients with glaucoma and ocular hypertension. The mean ACD prior to treatment with Latanoprost and before the instillation of 2% Pilocrapine was 3.14 + 0.46 mm (SD); and an hour after the instillation of Pilocarpine, 3.04 + 0.46 mm (SD). After a month of treatment with Latanoprost (and prior to instillation of Pilocarpine), ACD was 2.98 + 0.44 mm (SD); and an hour after instillation of Pilocarpine was 2.91 + 0.49 mm (SD). These were all statistically significant at P < 0.05. These supported the authors' conclusions that Latanoprost decreases the ACD in patients with glaucoma or ocular hypertension after a month of treatment. Latanoprost has been found to stimulate collagen gel contraction mediated by human corneal fibroblasts, and this might affect corneal shape, affecting measurement of intraocular pressure.¹ The A-mode ultrasound used is likewise a contact instrument, so the ACD measurement may have been affected by an altered cornea. Measurements may be more accurate in future studies, if non-contact instruments such as the IOL Master, ultrasound biomicroscope (UBM) or anterior segment OCT (AS-OCT) are used. Long-term randomized studies with a larger population size are needed to follow patients on long-term Latanoprost. Of special interest are patients with angle closure glaucoma, who should be followed up to see if there is indeed angle shallowing with long-term use of Latanoprost. Patients with primary open angle glaucoma should likewise be followed, to see if they later convert to angle closure glaucoma.

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