study Periorbital Changes Assoc With Topical Bimatoprost
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free skin care · Tue May 15, 2012 7:11 pm

not sure if anyone's posted about this study before- here's the abstract

Ophthalmic Plastic & Reconstructive Surgery:
July/August 2008 - Volume 24 - Issue 4 - pp 302-307
doi: 10.1097/IOP.0b013e31817d81df
Article
Periorbital Changes Associated With Topical Bimatoprost

Filippopoulos, Theodoros M.D.*1; Paula, Jayter S. M.D., Ph.D.†1; Torun, Nurhan M.D.‡; Hatton, Mark P. M.D.§; Pasquale, Louis R. M.D.*; Grosskreutz, Cynthia L. M.D., Ph.D.*
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Abstract

Purpose: To describe periorbital changes induced by chronic topical therapy with daily bimatoprost 0.03% (Lumigan, Allergan Inc., Irvine, CA, U.S.A.).

Methods: A clinical investigation of 5 nonconsecutive patients with unilateral glaucoma treated daily with topical bimatoprost 0.03% for up to 4 years prior to presentation.

Results: In eyes treated with bimatoprost 0.03% the authors noted periorbital fat atrophy, deepening of the upper eyelid sulcus, relative enophthalmos, loss of the lower eyelid fullness, and involution of dermatochalasis compared with the fellow untreated eye. By inspecting old photographs the authors confirmed that these unilateral changes were not present prior to starting bimatoprost. In addition, these changes were partially reversible after discontinuation of the medication, whenever that was possible. In 2 cases imaging studies confirmed the clinical impression that these findings were not related to primary orbital pathology.

Conclusions: Physicians and patients should be aware of the potential of bimatoprost 0.03% to produce periorbital changes.

free skin care · Thu May 17, 2012 4:48 am

lagomorph wrote:

not sure if anyone's posted about this study before- here's the abstract

Ophthalmic Plastic & Reconstructive Surgery:
July/August 2008 - Volume 24 - Issue 4 - pp 302-307
doi: 10.1097/IOP.0b013e31817d81df
Article
Periorbital Changes Associated With Topical Bimatoprost

Filippopoulos, Theodoros M.D.*1; Paula, Jayter S. M.D., Ph.D.†1; Torun, Nurhan M.D.‡; Hatton, Mark P. M.D.§; Pasquale, Louis R. M.D.*; Grosskreutz, Cynthia L. M.D., Ph.D.*
Collapse Box
Abstract

Purpose: To describe periorbital changes induced by chronic topical therapy with daily bimatoprost 0.03% (Lumigan, Allergan Inc., Irvine, CA, U.S.A.).

Methods: A clinical investigation of 5 nonconsecutive patients with unilateral glaucoma treated daily with topical bimatoprost 0.03% for up to 4 years prior to presentation.

Results: In eyes treated with bimatoprost 0.03% the authors noted periorbital fat atrophy, deepening of the upper eyelid sulcus, relative enophthalmos, loss of the lower eyelid fullness, and involution of dermatochalasis compared with the fellow untreated eye. By inspecting old photographs the authors confirmed that these unilateral changes were not present prior to starting bimatoprost. In addition, these changes were partially reversible after discontinuation of the medication, whenever that was possible. In 2 cases imaging studies confirmed the clinical impression that these findings were not related to primary orbital pathology.

Conclusions: Physicians and patients should be aware of the potential of bimatoprost 0.03% to produce periorbital changes.

WOW...that is important information. Thanks for sharing!

Fri May 18, 2012 1:47 am

Thank you for posting this article. The side effect of periorbital fat loss is definitely evident, as pictured in patients in the article Prostaglandin-Associated Periorbitopathy, (Louis R. Pasquale). Another article that may only be accessed by subscription shows Asian patients with the same effects (Latanoprost Therapy After Sunken Eyes Caused by Travoprost or Bimatoprost, Shunsuke Nakakura, Hitoshi Tabuchi, and Yoshiaki Kiuchi). However, before posters start throwing out their bottles of Latisse or Careprost, we should be aware that these studies have only been conducted on patients that were using bimatoprost to treat glaucoma. There is still a difference between applying one drop onto the eyeball, and applying one drop onto the upper eyelid.

If users are worried about this possible side effect, they should actively employ the following tips:

1) Use a thin eyeliner brush to apply the upper eyelashes (e.g. Bare Escentuals Eyeliner Brush, $12). The brushes that are sold for use with Latisse are too thick, and should not be used. The thinner the brush, the better .

2) When applying the product, the brush should just be moistened, not dripping wet. Ideally, it should leave a fine line that dries in seconds. If the product is dripping or stays wet for more than two minutes, you’re using too much and need to decrease the amount.

3) Do not apply the product prior to going to bed. There is a small chance of the liquid migrating down to the crease as you lay down. Not only does it increase the chance of the eyelid turning red, but also it goes directly to the spot where those patients experienced a loss of fat in the eyelid.

4) After six months, the user should consider going into “maintenance mode”, and use the product no more than two or three times a week.

5) Do not apply the product to the lower eyelashes. The liquid does migrate a bit onto the lower lashes as one blinks anyway.

The good news is that once patients stopped using bimatoprost, the results were reversed, as seen in the article by Nakakura et al. The article found that results were reserved when patients stopped using bimatoprost and travoprost and switched to latanoprost. A couple of articles noted that in 2010, it was reported latanoprost also causesd some fat loss. However, photographs in the article by Nakakura et al. show that latanoprost did not affect the eyelids as the patients` conditions improved. The paper also noted the following: “In our hospital database, we found this “sunken” eye complication in two patients of 77 (2.6%) on travoprost and four patients (two other patients under observation) of 86 patients (4.7%) on bimatoprost” (Nakakura et al. 1142). The percentages are small in users.

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