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W.J. Scherer, T. Ghuman; Association Between Latanoprost Use and Development of Choroidal Neovascular Membrane in Patients With Concurrent Glaucoma and Age–related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2005;46(13):194.
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Purpose: Matrix metalloproteinases (MMP’s) are a family of enzymes that act to degrade extracellular matrix molecules such as collagen, elastin and gelatin. The glaucoma medication latanoprost increases uveoscleral outflow, thus lowering intraocular pressure in primary open angle glaucoma (POAG), by activating MMP's (MMP's 1, 2, 3 and 9) in the ciliary body. It has been reported that latanoprost may also gain access to the posterior segment and induce cystoid macular edema, although the mechanism is unknown. In the choroid, activation of some of the same subtypes of MMP's (particularly MMP's 2 and 9) has been implicated in the formation of choroidal neovascular membranes (CNVM's) in age–related macular degeneration (AMD). This study examines whether topical latanoprost, or prostaglandin use, is associated with a greater risk of CNVM formation in patients diagnosed with both AMD and POAG. Methods: A retrospective record review was performed to identify patients with a concurrent diagnosis of AMD and POAG between 1998 and 2004. 484 eyes were identified and grouped as wet (n = 65) or dry (n = 419) AMD. Latanoprost and prostaglandin usage were compared between the two groups. Usage of other glaucoma medications were also compared. A minimum of 1 year of medication use and no history of CNVM prior to the onset of medication use were required for inclusion in the study. Results: 38% (158/419) of dry and 42% (27/65) of wet AMD eyes were using latanoprost (p = 0.28, NS). 53% (222/419) of dry and 62% (40/65) of wet AMD eyes were using a topical prostaglandin (p = 0.11, NS). No significant differences in other glaucoma medication usage were noted between the groups. Lens status (phakic v pseudophakic) did not affect the findings. Conclusions: No association between long term topical latanoprost or prostaglandin use and CNVM development was found in patients with AMD and POAG.
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