Study finds prostaglandins change ocular surface
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The ocular surface was found to change in patients treated with prostaglandin analogues, according to a literature review published in the Journal of Ophthalmology.
“We focused on the effect on the cornea and conjunctiva of [prostaglandin analogue]-treated individuals, with the following aspects summarized: corneal biomechanical properties, [central corneal thickness], conjunctiva, wound healing and dry eye,” Wencui Shen, MD, of the Tianjin Eye Hospital and Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science at Nankai University in Tianjin, China, and colleagues wrote.
The main issues found with PGA therapies are the side effect of conjunctival hyperemia and the delay found in corneal wound healing, the researchers stated. Furthermore, studies have also demonstrated that a large proportion of patients using topical PGAs suffer from ocular surface disease (OSD), with half suffering from dry eye.
This review shows there is a significant relationship between changes in ocular surface and PGAs. PGAs demonstrate a considerable influence on ocular surface of patients, whether in direct structure of the cornea or in the pathological change of OSD, they said.
“These disadvantages of PGAs encourage us to invent more precise methods recording medicated IOP and to develop more effective and safer antiglaucoma drugs,” the authors wrote.
The researchers advised that IOP measurements should be adjusted during therapy, and that OSD caused by PGAs should be recognized at patient follow-up. – by Erin T. Welsh
Disclosure: The authors report no relevant financial disclosures.
Perspective
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Daniel Roberts, OD, PhD, FAAO
This review article brings further attention to potential adverse effects of prostaglandin analogs, which are widely used in the management of glaucoma. Although this class of medications has demonstrated great effectiveness for many years, the authors provide a reminder, and perhaps some introduction, about possible side effects to the ocular surface and corneal integrity. Potential adverse effects on corneal thickness, tear protein composition, wound healing, meibomian gland dysfunction and dry eye disease are important for practitioners to be aware of, as clinical management may be influenced in certain situations.
Appropriately, this article also brings attention to much of the uncertainty surrounding current research into some of the potential medication effects, such as what is attributed to active ingredients vs. preservatives or other characteristics. Clearly, there is still much work needed to prove whether some relationships really exist, and, if so, what the precise underlying mechanisms may be.
This short review article provides a useful summary of some relevant concepts for the practicing optometrist and highlights many pertinent references. The writing in this piece is difficult to follow at times, but it is dedicated to an important topic and contains helpful information.
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