Massimo Lorusso, Micelli Ferrari Luisa, Nikolopoulou Gisotti Eleni, Zito Roberta, MicelliFerrari Tommaso, Anna Ferretta, Bordinone Marco Antonio
Unit of Ophthalmology, "F. Miulli" Hospital, Acquaviva delle Fonti (BA), Italy.
Ophthalmology Department, University of Bari, Bari, Italy.
Eur J Ophthalmol. 2022 May;32(3):NP19-NP22. doi: 10.1177/1120672121990573. Epub 2021 Jan 28.
Bimatoprost 0.03% is an intraocular pressure (IOP) lowering prostaglandin analog with different adverse side effects such as potential ocular inflammatory effect and ocular hyperemia.
We report a case of 80-year-old woman diagnosed with bilateral glaucomatous uveitis, and choroidal detachment in the left eye after topical bimatoprost administration. During the patient's hospitalization, Bimatoprost treatment was discontinued and local steroid therapy was administrated. After 1 week we reported a marked improvement of visual acuity, IOP measurement was 12 mmHg in both eyes. Anterior segment examination showed complete resolution of conjunctival and pericheratic hyperemia with significant reduction of endothelial precipitates in both eyes.
In our case, the anterior granulomatous uveitis occurred in both pseudophakic eyes and the choroidal detachment (CD) in the eye that previously had trabeculectomy. Probably the scar tissue of the trabeculectomy allowed a better penetration of the Bimatoprost or a greater sensitivity due to an altered trabecular tissue. This work confirms that the onset physiopathology mechanism of granulomatous uveitis and CD following instillation of Bimatoprost remains uncertain.
0.03%的比马前列素是一种降低眼压的前列腺素类似物，具有不同的不良反应，如潜在的眼部炎症效应和眼部充血。
我们报告一例80岁女性患者，在局部应用比马前列素后被诊断为双侧青光眼性葡萄膜炎，左眼脉络膜脱离。在患者住院期间，停用了比马前列素治疗并给予局部类固醇治疗。1周后，我们报告视力有明显改善，双眼眼压测量值为12mmHg。眼前节检查显示结膜和周边充血完全消退，双眼内皮细胞沉淀物显著减少。
在我们的病例中，前葡萄膜炎肉芽肿发生在双眼假晶状体眼中，脉络膜脱离发生在先前接受小梁切除术的眼睛中。可能小梁切除术的瘢痕组织使比马前列素的穿透性更好，或者由于小梁组织改变而导致更大的敏感性。这项研究证实，滴用比马前列素后肉芽肿性葡萄膜炎和脉络膜脱离的发病生理机制仍不确定。
