Abstract
Purpose::
To study prospectively using optical coherence tomography (OCT) whether topical latanoprost induces macular disorders 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 latanoprost q.d. (n=10) or lubricant drop q.d. (control group) (n=10). Half of the patients of each group presented intact posterior capsule, while the other half presented ruptured posterior capsule (Nd:YAG laser). 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. OCT scanning was repeated six times, and the smallest value was used as the foveal thickness.
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. There was no statistically significant increase in mean foveal thickness from baseline when patients instilled placebo (P>0.0610). A statistically significant increase in retinal thickness in the fovea from baseline was observed when patients instilled latanoprost (P<0.0004). No changes were observed in visual acuity in both groups. Mean retinal thickness in the fovea were significantly higher in the latanoprost group during all follow-up (P<0.0007). Furthermore, there were statistically significant differences between mean foveal thickness in latanoprost treated eyes with broken posterior capsule when compared with intact posterior capsule (P<0.0461). When comparing only the patients with intact posterior capsule, there was a statistically significant difference in foveal thickness between patients treated with latanoprost (236.4 ± 29.4 µm) and placebo (197.8 ± 19.3 µm) only with 30 days of treatment. Among the patients with broken posterior capsule, the values of the mean foveal thickness were significantly higher in latanoprost group when compared with control group during all follow-up (p<0.0001).
Conclusions::
Latanoprost 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. We recommend caution when using latanoprost in pseudophakic patients.
Clinical Trial::
www.actr.org.au ACTRN012606000265572
Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • intraocular pressure • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)