Purchase this article with an account.
Deepak P. Edward, Smajo Osmanovic, Todd Woodruff, Richard Lehrer, Richard Ellison, M.Alice Wiest; The Effects of Xalatan, Travatan and Lumigan on Periocular Skin Pigmentation. Invest. Ophthalmol. Vis. Sci. 2011;52(14):231.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Periocular skin hyperpigmentation is a known side effect of topical prostaglandin analogues. Assessment of this condition has been subjective and limited to small case series. Differences in the incidence and degree of hyperpigmentation between prostaglandin analogues remain unknown. In this study, we objectively measured changes in periocular skin color induced by latanoprost, bimatoprost, and travoprost treatment over a one year period in newly-diagnosed glaucoma and ocular hypertension patients.
93 eyes of 73 newly diagnosed patients were recruited. Appropriate inclusion and exclusion criteria were applied. We measured periocular skin color with the Minolta Chromameter CR-400 and the L*a*b* system recommended by Commission Internationale de l’Eclaraige. Patients were randomized to latanoprost, bimatoprost, and travoprost treated eyes, 6 predetermined areas on and around the upper and lower eyelid and 2 areas of the face/cheek were measured at baseline, 6 weeks, 3 months, 6 months, 9 months and 1 year after starting therapy. The L* value, (luminance, representing relative lightness ranging from total black to total white) was measured and recorded at each time point. The data was analyzed using generalized estimating equations and Cox regression.
A decrease in L* (skin darkening) was noted early at 6 weeks in some indviduals but not consistently until three months, and then peaked between 6-9 months for all three drugs. The changes in L* were not statistically significant between medications (range in change in L* for all meds -0.14 to -0.68). The degree of change was greater in Caucasians than African Americans, and greater for females than males but did not show a statistically meaningful variance. Longitudinally, compared to latanoprost, bimatoprost elicited a non-significant mean -0.52 change in L*, while travoprost had a much smaller -0.14 finding. At month 12 the L* values appeared to reverse with the average change at 9 months being -0.48 and -0.18 at 12 months.
This study demonstrates that all three prostaglandin analogues induce darkening of the eyelid skin that is objectively detected as a decrease in the L* value. While not reaching levels of statistical significance, this change was more dramatic for bimatoprost, more common in Caucasians and in women. The greatest degree of change occurred at 6 and 9 month after initiating treatment.
Clinical Trial: :
This PDF is available to Subscribers Only