ASOPRS 2014 Fall Syllabus - page 170

ASOPRSFall Scientific SymposiumSyllabus
170
T17
Periocular Changes associatedwithSixMonths of Topical Bimatoprost
in theRabbit
TiffanyKent, PhilipCuster. Ophthalmology,WashingtonUniversity, St. Louis,MO, UnitedStates
Introduction:
Topical prostaglandin analogues (PGAs) are frequently used for both primary and secondary treatment of glaucoma.
Physicians are becoming increasingly aware that isolated patients can develop prostaglandin associated orbitopathy, characterized
by deepening of the superior sulcus, reduction of dermatochalasis, enophthalmos, and ptosis.There have also been isolated reports
of increased tension of the eyelidmargins.
1-4
We performed a prospective animal study to both confirm the causal relationship and to
better characterize the nature of these eyelid changes.
Methods:
Following institutional approval, femaleNew ZealandWhite rabbitswere separated into three treatment groups
(n=3 rabbits/group): Group 1: artificial tears OU, Group 2: 0.3% bimatoprost OU, Group 3: untreated.At the end of both 3-month and
6-month treatment periods, animalswere sedated andmeasurements taken of both horizontal length and eyelid distraction from the
globe. Subsequently, the animalswere euthanized and the eyelids examined histologicallywith hemotoxalin and eosin (H&E) staining.
Statistically analysiswas performed using SPSS,with a significance 0.05, usingANOVA and post-hoc analysiswith the least-
significant difference test.
Results:
Following both 3 and 6months of treatment (Table 1), animals that received topical PGA drops demonstrated significantly
smaller eyelid fissurewidths, than those treatedwithATs (p=0.007 for 3months, p<0.001 for 6months) or untreated controls
(p<0.001 for both 3 and 6months). Similarly,eyelid distraction data demonstrated a similar trend,with PGA treated eyelids having
significantly less distractibility thanATs treated eyelids (p=0.002 for uppers at 3months, p<0.001 for uppers at 6months, p<0.001
for lowers at both 3 and 6months) or untreated controls (p<0.001 for uppers at both 3 and 6months and P<0.001 for lowers at
3months and p=0.008 for lowers at 6months). Histological anayslis of H&E sections of all tissues did not reveal any notable
difference between groups.
Conclusions:
Daily topical PGA drops inNew ZealandWhite rabbits resulted in horizontal shortening of the eyelids and acquired
blepharophimosis.Therewas increased horizontal tension of the treated eyelids on the eyelid distraction test.These eyelid changes
are similar to those observed in human patients on PGA therapy.
References:
1) “Deepening of the Upper Eyelid Sulcus Caused by 5Types of ProstaglandinAnalogs”, Inoue, et al., J Glaucoma
2013Oct-Nov;22(8):626-31
2) “Eyelid and EyelashChanges DueTo ProstaglandinAnalogTherapy in Unilateral Treatment Cases”,Yoshino et al, Jpn JOphthalmol
2013Mar;57(2):172-8
3) “Adverse Periocular Reactions to FiveTypes of ProstaglandinAnalogs”, Inogue, et al., Eye 2012Nov;26(11):1465-72
4) “Iris and Periocular Adverse Reactions to bimatoprost in Japanese patientswith glaucoma or ocular hypertension”, Inoue, et al.,
Clinical Ophthalmology 2012;6:111-6
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—Thursday,October 16, 2014
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