Travoprost Induced Granulomatous Anterior Uveitis

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Abstract

Purpose. To report a case of granulomatous anterior uveitis caused by travoprost. Methods. Single observational case report. Results. A 71-year-old who was fit and healthy presented with bilateral granulomatous anterior uveitis 2 months after he was started on travoprost in both eyes. There was no past history of uveitis. Blood test and radiological investigation were unremarkable. Travoprost was stopped. The uveitis resolved on topical steroid treatment. A rechallenge with travoprost was attempted in one eye. The inflammation recurred in this eye only. This subsided with the cessation of travoprost alone without topical steroid. Conclusion. This is the first case report of travoprost causing granulomatous anterior uveitis. The uveitis recurred with a rechallenge. Changing the prostaglandin analogue to another topical treatment may be adequate to cease the inflammation.

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Most cited references 9

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Prostaglandin F2 alpha and its analogs induce release of endogenous prostaglandins in iris and ciliary muscles isolated from cat and other mammalian species.

S Y Yousufzai, Ghada Abdel-Latif, Z. Ye (1996)

Prostaglandin F2 alpha (PGF 2 alpha) and its analog latanoprost are effective in lowering intraocular pressure (IOP) in both animal and human subjects. There is mounting experimental evidence now which indicates that the IOP-lowering effect of these PGs occurs through an increased uveoscleral outflow of aqueous humor. The ciliary muscle constitutes the main resistance in this pathway. Work from several laboratories, including our own, has shown that in this smooth muscle PGF 2 alpha has little effect on cAMP accumulation or on Ca2+ mobilization. In the present study, we hypothesized that some of the effects of PGF2 alpha and its analogs may be mediated through the release of endogenous PGs. The purpose of this work was to determine whether or not PGF2 alpha and its analogs can enhance the release of endogenous PGs in iris and ciliary muscles isolated from different species. This report documents for the first time that exogenous PGF2 alpha and its analogs, PhXA85 and latanoprost, stimulate the formation of PGE2, PGD2 and PGF2 alpha in iris and ciliary muscles isolated from cat, bovine, rabbit, dog, rhesus monkey and human. PG-induced PG release was demonstrated by means of both radioimmunoassay and radiochromatography. Kinetic studies on cat iris revealed that PGF2 alpha-induced PGE2 release is time (t 1/2 = 1.7 min) and dose-dependent (EC50 = 45 nM). The increase in PGE2 release was blocked by indomethacin (Indo) and by dexamethasone in a dose-dependent manner with IC50 s of 9.2 nM and 2.6 microM, respectively. Furthermore, dexamethasone inhibited arachidonic acid (AA) release, suggesting the involvement of phospholipase A2 in PGF2 alpha-induced PG release. The data presented demonstrate that PGF2 alpha and its analogs interact with the PG receptor to stimulate phospholipase A2 and release AA for PG synthesis. Relaxation of ciliary muscle by PGF2 alpha and its analogs, via release of endogenous PGE2, a potent activator of the adenylate cyclase system, could in part explain how these PGs may increase uveoscleral outflow and consequently lower IOP.

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Sakari Suominen, Juha Välimäki (2006)

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Acute anterior uveitis and corneal edema associated with travoprost.

Jessica W. Faulkner, S E Burk (2003)

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Author and article information

Journal

Journal ID (nlm-ta): Case Rep Ophthalmol Med

Journal ID (iso-abbrev): Case Rep Ophthalmol Med

Journal ID (publisher-id): CRIM.OPHMED

Title: Case Reports in Ophthalmological Medicine

Publisher: Hindawi Publishing Corporation

ISSN (Print): 2090-6722

ISSN (Electronic): 2090-6730

Publication date (Print): 2011

Publication date (Electronic): 14 December 2011

Volume: 2011

Electronic Location Identifier: 507073

Affiliations

Eye Care Centre, Leighton Hospital, Crewe, Cheshire CW1 4QJ, UK

Author notes

*Patrick Chiam: pjtchiam@ 123456yahoo.com

Academic Editors: A. A. Bialasiewicz, C.-Y. Cheng, and S. M. Johnson

Article

DOI: 10.1155/2011/507073

PMC ID: 3350054

PubMed ID: 22606464

SO-VID: 12111b11-5022-4ce5-aa81-1bc3e3780bf4

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.