Abstract
Purpose: :
To study prospectively using optical coherence tomography (OCT) whether topical prostaglandin analogues induce retinal disorders, such as cystoid macular edema, in patients that underwent uneventful cataract surgery.
Methods: :
Randomized, masked-observer, one month, clinical trial. Pseudophakic patients that underwent uneventful cataract surgery were treated with bimatoprost q.d. (n=10), latanoprost q.d. (n=10) or travoprost q.d. (n=10). Half of the patients of each group presented ruptured posterior capsule (Nd:YAG laser). Patients were excluded from the study if they had a history of uveitis or CME, or a history of intraocular surgery or a laser procedure within 6 months of baseline. We evaluated the blood-retinal barrier status assessed by the OCT measurement of retinal thickness in the fovea. Before initiation of the study and after 15 and 30 days of treatment, OCT images were taken, and the visual acuity examination was performed. To evaluate retinal thickness in the fovea accurately, OCT scanning was repeated six times, and the smallest value was used as the retinal thickness in the fovea.
Results: :
There were no statistically significant differences between baseline mean age, mean retinal thickness in the fovea, and mean interval between cataract surgery and baseline among the groups. A statistically significant increase in retinal thickness in the fovea from baseline was observed when patients instilled bimatoprost (P<0.0291), latanoprost (P<0.0082), and travoprost (P<0.0035). However, there were no significant differences in mean foveal thickness measurements among the groups during all follow-up (P>0.1041). When we evaluated the effect of posterior capsule status on mean foveal thickness measurements during follow-up, we observed that, although there were no significant difference at baseline (P=0.2268), in eyes with a ruptured posterior capsule the mean foveal thickness was significantly higher (P<0.0003). No changes were observed in visual acuity. Two bimatoprost-treated eyes, 1 latanoprost-treated eye, and 1 travoprost-treated eye developed cystoid macular edema according OCT maps (P=0.7494); all cases resolved after discontinuation of the prostaglandin analogue.
Conclusions: :
Bimatoprost, latanoprost, and travoprost may lead to disruption of the blood-retinal barrier in pseudophakic patients, and it is more probable to occur in patients with broken posterior capsule.
Clinical Trial: :
www.actr.org.au ACTRN12606000266561
Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • intraocular pressure • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)