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Editors Selection IGR 8-2
Medical treatment: Bimatoprost and fat atrophy
Comment by Andreas Boehm on:
20949 Orbital fat atrophy in glaucoma patients treated with topical bimatoprost - can bimatoprost cause enophthalmos?, Tappeiner C; Perren B; Iliev ME et al., Klinische Monatsblätter für Augenheilkunde, 2008; 225: 443-445
The paper by Tappeiner et al. (790) is the second report in the literature highlighting a possible relation between the topical treatment with bimatoprost and deepening of the lid sulcus, suggesting that bimatoprost might lead to a localized perorbital fat atrophy. A third report by Filippopoulos and coworkers was published recently thereafter (Optom Vis Sci 2004; 81: 574-577.) Tappeiner and coworkers report five cases with a deep lid sulcus and Hertel exophthalmometry measurements, which were suspicious for an enopththalmos. The authors ruled out various other possible causes. As all patients were on bimatoprost therapy for almost five years, the authors hypothesized that the bimatoprost therapy might have caused these periorbital changes. As the exam was only cross-sectional and no longitudinal follow-up was available, it remains unclear whether or not the reported changes were linked to bimatoprostt. Additionally in a patient with unilateral bimatoprost treatment Hertel exophthalmometry showed no significant difference between eyes. Therefore, the paper gives another hint about the possible relation but is unable to prove the hypothesis. To verify this issue, a longitudinal study seems necessary. Interestingly, so far there is no report in the literature about possible similar effects with latanoprost or travoprost. It will be interesting to see if a higher alertness with regard to this possible side effect will lead to a higher number of reported cases.
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