Role of Prostaglandin Analogue in Glaucoma and its Side Effects
Author(s): Shrutika Tathod and Shailesh Nagpure*
Abstract
Glaucoma is disorder in which degeneration of gangliocytes in retina takes place. Intraocular pressure increases in glaucoma. So, only therapeutic approach for consideration of this disorder is to lower the pressure inside which get increased. Prostaglandin analogue causes reduce in intra ocular pressure. Treatment also includes laser therapy and incisional surgery. Laser surgery to create small openings in the trabecular meshwork of eye from which aqueous humor can drain to reduce intraocular pressure which is called as laser trabeculoplasty and selective laser treatment of same, both, increases outflow of aqueous humor through trabecular meshwork. Surgical procedures include trabeculoctomy, implantation of drainage tube or ciliary body cyclodestruction. Still the treatment has to start with intra ocular pressure reduction. Major drug classes which have therapeutic importance for Glaucoma includes cholinergic, drugs that increases response fron the adrenergic receptors, carbonic anhydrase inhibitors, prostaglandin analogues (PGAs). Prostaglandin analogue can be used in combination with other ant glaucoma drugs. PGAs include mainly latanoprost, Bimatoprost, traboprost. Sustained release intra ocular drugs also have long term intra ocular pressure lowering in glaucoma. Latanoprost and Traboprost both significantly reduce twenty four hours intra ocular pressure. Traboprost have greater hypotensive efficacy. But side effects are also there. Latanoprost causes mild Conjunctival hyperaemia. Irides get damaged during Latanoprost treatment. But Latanoprost do not cause uveitis or cystoid macular oedema, systemic adverse effects. Also it do not have any effect on routine blood analysis. Travoprost causes little diurnal fluctuations but causes decrease intra ocular pressure. Bimatoprost appears more effective than Travoprost . Patient show better tolerance for Latanoprost. Travoprost is better for exfoliative glaucoma. Ketorolac increases the effect of prostaglandin analogue that is Latanoprost, Travoprost, and Bimatoprost. First commercially available prostaglandin analogue is isopropyl unoprostone. It does not cause any adverse effects usually. Prostaglandin can cause other side effects like pigment deposition on periocular region , damage to blood aqueous barrier and cystoid macular oedema i.e. disorder which affects the central retina or macula, swap in eywlashes ,iris pigmentation, etc.