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M. Mroz, M.B. Abelson; Ocular Surface Changes Associated with the Use of Bimatoprost 0.03% . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4417.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the effect of bimatoprost 0.03% on the ocular surface in patients with glaucoma or ocular hypertension. Methods: Open-label, single-center evaluation. Patients underwent a 5 week washout of their previous treatment and were started on bimatoprost 0.03% QD for 60 days. Evaluations were performed at Day 0 (prior to first instillation of bimatoprost), 7, 30, and 60. Tear turnover rate (TTR) was determined quantitatively by means of fluorophotometry (Fluorotron Master II, OcuMetrics). Fluorescein staining (FS) patterns were evaluated in 5 regions of the ocular surface (inferior, superior, central, temporal, nasal) using a standardized 0-4 scale (0 = none, 4 = severe). Lissamine green staining (LGS) patterns were evaluated using a similar method. Impression cytology specimens were collected and cells were processed for flow cytometry using monoclonal antibodies to HLA-DR and ICAM-1 antigens (Beckman Coulter). Percentages of positive cells were calculated and levels of expression quantified after conversion into standardized units of fluorescence (ABC units). Bulbar conjunctival biopsy specimens were obtained from 15 of 31 patients at Day 7 and examined using H&E; stain. Results: All 31 patients enrolled completed the study. Mean TTR was significantly higher at Days 7 (+35%; P = 0.002) and 30 (+43%; P = 0.001) and similar to baseline at Day 60 (P = 0.507). Mean FS (inferior, superior, temporal, nasal) and mean LGS (temporal, nasal) decreased significantly from baseline to follow-up. Expression of HLA-DR and ICAM-1 decreased significantly from baseline. For example, mean expression of HLA-DR was 507,618 ABCs at Day 0, 146,987 at Day 7, 101,536 at Day 30, and 94,751 at Day 60. Biopsies (n = 15) showed no evidence of inflammation. Conclusions: Initiation of bimatoprost therapy appeared to be associated with a transient increase in TTR, which returned to baseline by Day 60. These changes in tear dynamics were most likely responsible for the observed decreases in fluorescein and lissamine green staining, and the decrease in expression of inflammatory cell-markers, HLA-DR and ICAM-1. This clinical and histological evidence suggests that bimatoprost is not damaging to the ocular surface.
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