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Patchinsky A, Petitpain N, Gillet P, Angioi-Duprez K, Schmutz JL, Bursztejn AC. Dermatological adverse effects of anti-glaucoma eye drops: a review. J Eur Acad Dermatol Venereol 2022; 36:661-670. [PMID: 35032359 DOI: 10.1111/jdv.17928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/18/2021] [Indexed: 11/28/2022]
Abstract
Many patients are treated for glaucoma. Like other drugs, anti-glaucoma eye drops may induce dermatological adverse effects. We aim to review the dermatological adverse effects secondary to the active agents in anti-glaucoma eye drops through a literature review. In January 2020, we queried PubMed using the following MeSH terms: glaucoma/drug therapy or glaucoma, open angle/drug therapy cross-referenced with parasympathomimetics/adverse effects or adrenergic agonists/adverse effects or carbonic anhydrase inhibitors/adverse effects or prostaglandins F, synthetic/adverse effects or adrenergic beta antagonists/adverse effects or ophthalmic solutions/adverse effects. The initial search identified 1128 studies, of which 49 were excluded for being in a foreign language, 15 for not involving eye drops, 968 for not focusing on adverse dermatological effects, and 11 for insufficient documentation or redundancy. After adding 38 linked studies, we finally analysed 123 studies. The ocular and periocular dermatological adverse effects of eye drops are contact dermatitis, hyperpigmentation, prostaglandin analogue periorbitopathy, mucous membrane pemphigoid, eyelash depigmentation, skin hypertrichosis, and rare cases of melanoma and skin depigmentation. The reported distant dermatological adverse effects are psoriasis, excessive sweating, lichen planus, alopecia, toxic epidermal necrolysis, erythema multiforme, erythroderma, subacute cutaneous lupus erythematosus, nail pigmentation and bullous pemphigoid. Most of the cutaneous adverse effects of anti-glaucoma eye drops are ocular and periocular and induced by prostaglandin analogues. Distant adverse effects are rare and sometimes questionable but should be kept in mind, especially mucous membrane pemphigoid, which could lead to blindness. The role of preservatives, such as benzalkonium chloride, should also be considered.
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Affiliation(s)
- Alexandra Patchinsky
- Service de Dermatologie, CHRU DE NANCY Brabois, Bâtiment des Spécialités Médicales, rue de Morvan, 54511, Vandœuvre lès Nancy, France
| | - Nadine Petitpain
- Service de Pharmacovigilance, Bâtiment de Biologie Médicale et de Biopathologie, CHRU DE NANCY Brabois, rue de Morvan, 54511, Vandœuvre lès Nancy, France
| | - Pierre Gillet
- Service de Pharmacovigilance, Bâtiment de Biologie Médicale et de Biopathologie, CHRU DE NANCY Brabois, rue de Morvan, 54511, Vandœuvre lès Nancy, France.,Université de Lorraine, CNRS, IMoPA, F-54000, Nancy, France
| | - Karine Angioi-Duprez
- Service d'Ophtalmologie, Hôpital d'Adultes, CHRU DE NANCY Brabois, rue du Morvan, 54511, Vandœuvre lès Nancy, France
| | - Jean Luc Schmutz
- Service de Dermatologie, CHRU DE NANCY Brabois, Bâtiment des Spécialités Médicales, rue de Morvan, 54511, Vandœuvre lès Nancy, France
| | - Anne Claire Bursztejn
- Service de Dermatologie, CHRU DE NANCY Brabois, Bâtiment des Spécialités Médicales, rue de Morvan, 54511, Vandœuvre lès Nancy, France
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Pérez-Rodríguez E, González-Pérez R, Poza P, Feliciano L, López-Correcher B, Matheu V. Contact dermatitis caused by latanoprost-containing eye drops with good tolerance to bimatoprost eye drops. Contact Dermatitis 2008; 58:370-1. [DOI: 10.1111/j.1600-0536.2007.01297.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bhatt R, Whittaker KW, Appaswamy S, Desai A, Fitt A, Sandramouli S. Prospective survey of adverse reactions to topical antiglaucoma medications in a hospital population. Eye (Lond) 2004; 19:392-5. [PMID: 15297863 DOI: 10.1038/sj.eye.6701515] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
AIM To identify the relative incidence and profile of adverse drug reaction (ADR) to various topical ocular hypotensives in a hospital setting. METHODS All the patients presenting in outpatients clinic and accident and emergency with an ADR to topical hypotensive agent from August 2000 to January 2001 were included in the study. Details regarding the type date of commencing the treatment, the date of developing ADR, time to resolution of the ADR were noted. RESULTS Over the period of 6 months, 66 patients presented with 73 ADRs. Brimonidine was the most frequent offending agent. In total, 23 (34.8%) presented with ADR after being commenced on treatment for more than 12 months. In all, 16 (24%) patients had IOP > 21 on presentation, eight (12%) patients underwent filtration surgery following the development of ADR. CONCLUSION Adverse drug reaction to ocular hypotensive agents is not uncommon and can have a major impact on glaucoma management. Delayed presentation and association with raised intraocular pressure presentation emphasise the need for effective patient education to encourage prompt reporting of ADR.
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Affiliation(s)
- R Bhatt
- Wolverhampton & Midland Counties Eye Infirmary, Wolverhampton WV3 9QR, UK
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Abstract
Glaucoma, a leading cause of blindness worldwide, is a chronic neurodegenerative disorder. Patients with glaucoma may require long-term administration of intraocular pressure (IOP)-lowering medications. These medications belong to several classes of molecules including beta-adrenergic blockers, cholinergic agents, alpha-adrenergic agonists, carbonic anhydrase inhibitors and ocular hypotensive lipids. Most adverse effects associated with IOP-lowering medications are mild and ocular in nature; however, several of them are associated with systemic risks as well as serious ocular effects, especially following chronic use. The following review discusses the acute and long-term effects of commonly used IOP-lowering medications.
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Affiliation(s)
- Joel S Schuman
- New England Eye Center, Tufts-New England Medical Center, Tufts University School of Medicine, 750 Washington Street, Box 450, Boston, MA 02111, USA.
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Delaney YM, Salmon JF, Mossa F, Gee B, Beehne K, Powell S. Periorbital dermatitis as a side effect of topical dorzolamide. Br J Ophthalmol 2002; 86:378-80. [PMID: 11914202 PMCID: PMC1771110 DOI: 10.1136/bjo.86.4.378] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To report periorbital dermatitis as a late side effect of topical dorzolamide hydrochloride (Trusopt), a drug used to reduce intraocular pressure. METHODS A retrospective study of 14 patients who developed periorbital dermatitis while using topical dorzolamide hydrochloride was undertaken. Six patients underwent patch testing for sensitivity to Trusopt, dorzolamide hydrochloride, and the preservative benzalkonium chloride. RESULTS The periorbital dermatitis occurred after a mean period of 20.4 weeks of commencing dorzolamide hydrochloride therapy. 13 patients had used preserved topical beta blocker treatment for a mean period of 34.2 months without complication before the introduction of dorzolamide. In eight (57.1%) the dermatitis resolved completely after discontinuing dorzolamide but in six (42.9%) resolution of the dermatitis did not occur until the concomitant preserved beta blocker was stopped and substituted with preservative free drops. Patch testing for sensitivity to Trusopt, dorzolamide hydrochloride, and benzalkonium chloride was negative. CONCLUSION These findings suggest that dorzolamide can cause severe periorbital dermatitis. Although the dermatitis may resolve when dorzolamide is discontinued, this does not always occur and in some patients all topical medication containing benzalkonium chloride needs to be stopped.
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Affiliation(s)
- Y M Delaney
- Department of Ophthalmology, John Radcliffe Hospitals NHS Trust, Oxford, OX2 6HE, UK
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Abstract
BACKGROUND Much experience has been gained with the use of older classes of antiglaucoma agents--topical beta-adrenergic-receptor antagonists, nonselective adrenergic-receptor agonists, oral carbonic anhydrase inhibitors, and cholinergic agents. In the past decade, new drugs and classes of drugs used to treat glaucoma have become available, including topical carbonic anhydrase inhibitors, prostaglandin analogues, and alpha2-adrenergic-receptor agonists. Extensive community-based use of antiglaucoma medications has led to an increased understanding of the acute and long-term safety and tolerability issues associated with their use. OBJECTIVE This paper reviews the side effects associated with the various classes of topical antiglaucoma drugs, with a particular focus on long-term safety issues.
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Affiliation(s)
- J S Schuman
- New England Eye Center, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
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