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Editors Selection IGR 10-4
Medical treatment: Latanoprost and iris darkening
Comment by Ian Grierson on:
21320 A study of histopathological features of latanoprost-treated irides with or without darkening compared with non-latanoprost-treated irides, Albert DM; Gangnon RE; Grossniklaus HE et al., Archives of Ophthalmology, 2008; 126: 626-631
Albert et al. (of which three were pathologists)(514) conducted a detailed, masked histopathological examination of iridectomy specimens taken at the time of glaucoma surgery. The specimens were from three groups of patients: (a) those not exposed to latanoprost (35 specimens); (b) those who had been on topical latanoprost, but there was no evidence of iris darkening (35 specimens); and © those who had been on topical latanoprost and underwent darkening (22 specimens).
Latanoprost-treated irises darken because of an increased amount of melanin within the melanocytes particularly those of the anterior border region of the iris stromaThe study is important, because of lingering concerns among ophthalmologists that prostanoid-induced iris darkening might be the harbinger of something more sinister than just a cosmetic change. The specimens were evaluated for premalignant alterations, differences in the amount of melanin granules present, cellularity, inflammation and vascular anatomy. There was no evidence of premalignant change in any specimen examined. The authors provided evidence that latanoprost-treated irises darken because of an increased amount of melanin within the melanocytes particularly those of the anterior border region of the iris stroma. A significant increase in thickness of the anterior border layer was identified in the specimens with iris darkening when compared to the other two groups.
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