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B.C. Leal, F.W. Medeiros, F.A. Medeiros, R.M. Santo, R. Susanna Jr; Histopathologic Study of the Conjunctiva of Patients in Bimatoprost Therapy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4397.
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Purpose: Bimatoprost is a efficacious ocular hypotensive agent, however conjuntival hyperemia has been reported as a side effect of its therapy. To evaluate a possible inflammatory basis of the hyperemia, we analysed , by means of light microscopy, the conjunctival specimens of patients who developed hyperemia during bimatoprost therapy. Material and Methods:Fifteen patients, divided in two groups, were included: group 1 comprising 9 patients with glaucoma or ocular hypertension in bimatoprost monotherapy and group 2 including 6 control patients with no history of glaucoma nor chronic use of topical medication. Patients in both groups had indication for cataract surgery.The degree of clinical hyperemia was recorded before the use of bimatoprost (group 1) and, preoperativelly (both groups). A conjunctival specimen was obtained during cataract surgery and processed for light microscopy. Results: In group 1, seven patients (77,8%) had moderate hyperemia; one had mild (11,1%); and one had traces of hyperemia (11,1%). In group 2, only one patient (16,7%) had traces of hyperemia. Histopathologic evaluation disclosed vascular congestion in seven patients (77,8%) in group 1 but also in the control group (5/6, 83,3%). Sign of acute inflammation with leukocytic margination was found in only one patient in group 1 but also in the control group, in the patient with traces of hyperemia. Mild chronic mononuclear infiltrate was observed in one patient of each group. Conclusion: In the present study, we were not able to find significant histopathologic differences between the study and the control groups. Vascular congestion without any sign of acute inflammatory phenomena was the most frequent feature in both groups, thus conjunctival hyperemia during bimatoprost therapy seems not to be correlated with an inflammatory response.
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