Shortening of Interpupillary Distance after Instillation of Topical Prostaglandin Analog Eye Drops

Ichiya Sano; Hidenori Takahashi; Satoru Inoda; Shinichi Sakamoto; Yusuke Arai; Yuji Takahashi; Akira Ohkubo; Hidetoshi Kawashima; Chihiro Mayama

doi:10.1016/j.ajo.2019.03.013

Shortening of Interpupillary Distance after Instillation of Topical Prostaglandin Analog Eye Drops

Am J Ophthalmol. 2019 Oct:206:11-16. doi: 10.1016/j.ajo.2019.03.013. Epub 2019 Mar 20.

Authors

Ichiya Sano¹, Hidenori Takahashi², Satoru Inoda¹, Shinichi Sakamoto¹, Yusuke Arai¹, Yuji Takahashi³, Akira Ohkubo⁴, Hidetoshi Kawashima¹, Chihiro Mayama⁵

Affiliations

¹ Department of Ophthalmology, Jichi Medical University, Tochigi, Japan.
² Department of Ophthalmology, Jichi Medical University, Tochigi, Japan; Department of Ophthalmology, Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan. Electronic address: takahah-tky@umin.ac.jp.
³ Department of Ophthalmology, Jichi Medical University, Tochigi, Japan; Takahashi Eye Clinic, Tochigi, Japan.
⁴ Department of Ophthalmology, Jichi Medical University, Tochigi, Japan; Ohkubo Eye Clinic, Tochigi, Japan.
⁵ Department of Ophthalmology, Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan.

PMID: 30902695
DOI: 10.1016/j.ajo.2019.03.013

Abstract

Purpose: To investigate changes in the interpupillary distance (IPD) after continual instillation of topical prostaglandin analogs (PGAs) in glaucoma patients as an objective indicator of prostaglandin-associated periorbitopathy (PAP).

Design: Retrospective, comparative case series.

Methods: A total of 152 institutional patients with glaucoma were enrolled in this study. Inclusion criteria were visual acuities exceeding 10/20 bilaterally and no intraocular surgery during observation. Intervention/observation procedures: First-time bilateral instillation of bimatoprost, travoprost, latanoprost, or tafluprost and IPDs measured by automatic refractometry. IPDs, intraocular pressures (IOPs), and refractive errors were measured before and after continual drug administration (treatment, 2-24 months).

Main outcome measurements: Post-treatment changes in IPDs. A total of 61 untreated patients served as controls.

Results: The IPDs shortened significantly (P < 0.001) after treatment (-0.80 ± 2.1 mm); the IPDs of control subjects remained unchanged (0.05 ± 0.96 mm; P = 0.69). The IPD change after bimatoprost instillation (-2.20 ± 0.97 mm) was significantly (P < 0.001) greater than with other PGAs (-0.65 ± 2.09 mm). The IOPs decreased significantly (P < 0.001) (-3.7 ± 4.3 mm Hg); the refractive errors did not change significantly (P < 0.099) (-0.07 ± 0.69 diopter) post-treatment. The percentages of subjects with 2-mm or greater decreases in IPD after bimatoprost, travoprost, latanoprost, or tafluprost were 85.7%, 20.0%, 18.2%, and 17.2%, respectively, and with 3-mm or greater decreases in IPD 35.7%, 12.0%, 14.5%, and 12.1%, respectively. The specificities were 93.4% and 100% in the control group, respectively, with IPD threshold changes of 2 and 3 mm or more, respectively.

Conclusions: The IPD decreased significantly after topical PGAs within 24 months. The effect was significantly greater with bimatoprost than with other PGAs. The noninvasive, immediate automatic refractometry measurement may be an objective numerical indicator of PAP.

Publication types

Comparative Study
Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Administration, Topical
Adult
Aged
Female
Glaucoma / diagnosis
Glaucoma / drug therapy*
Glaucoma / physiopathology
Humans
Intraocular Pressure
Male
Middle Aged
Ophthalmic Solutions / administration & dosage
Orbital Diseases / chemically induced*
Orbital Diseases / physiopathology
Prostaglandins, Synthetic / administration & dosage
Prostaglandins, Synthetic / adverse effects*
Pupil / drug effects*
Retrospective Studies

Substances

Ophthalmic Solutions
Prostaglandins, Synthetic