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Prostaglandin-Associated Periorbitopathy in Children and Young Adults with Glaucoma.

Publication ,  Journal Article
Kim, JS; Blizzard, S; Woodward, JA; Leyngold, IM; Liss, J; Freedman, SF
Published in: Ophthalmol Glaucoma
2020

OBJECTIVE: To evaluate for relative palpebral and orbital changes after long-term unilateral exposure to prostaglandin analogues (PGAs) in patients with childhood glaucoma. DESIGN: Prospective cross-sectional cohort study. PARTICIPANTS: A total of 29 patients with history of childhood glaucoma, who were treated unilaterally with PGAs for at least 12 months. METHODS: Based on 4 standardized clinical photographs (en face with eyes open, right and left side views with eyes open, and en face with eyes closed), 3 masked expert graders each independently selected the eye they perceived to have received unilateral PGA treatment by physical appearance alone and graded the following features relative to the other eye: (1) ocular (e.g., conjunctival hyperemia, iris heterochromia, and buphthalmos), (2) palpebral (e.g., eyelash trichomegaly, eyelash hypertrichosis, eyelid erythema, eyelid edema, eyelid hyperpigmentation, high upper eyelid crease, upper eyelid ptosis, upper and/or lower eyelid retraction, and eyelid skin atrophy with presence of telangiectasias), and (3) periorbital (e.g., superior sulcus hollowing, proptosis, enophthalmos, hypoglobus, and hyperglobus). An interrater reliability analysis was performed using the Fleiss kappa (κ) statistic to determine consistency among raters. MAIN OUTCOME MEASURES: Frequencies of each feature of prostaglandin-associated periorbitopathy (PAP); group consensus; interrater reliability of selected PGA-treatment laterality. RESULTS: Median unilateral PGA exposure time was 31.7 months (interquartile range: 18.8-44.3 months). Eyelash trichomegaly and hypertrichosis (n = 22, 76%), high upper eyelid crease (n = 20, 69%), upper eyelid ptosis (n = 14, 52%), and superior sulcus hollowing (n = 15, 52%) were the most frequently observed features of PAP in PGA-treated eyes compared with untreated fellow eyes. Most of these changes were mild, but 20% to 30% of patients exhibited moderate eyelash and/or eyelid changes. One patient had severe PAP after long-term unilateral PGA exposure. Group consensus with correctly selected laterality was achieved in all patients. The inter-rater reliability was excellent (κ = 0.815, P < 0.001, 95% confidence interval [0.605, 1.000]). CONCLUSIONS: Mild-to-moderate changes in the ocular adnexa can develop in children and young adults with long-term PGA exposure. Patients and their families should be educated on the possibility of PAP, especially when initiating monocular PGA therapy.

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Published In

Ophthalmol Glaucoma

DOI

EISSN

2589-4196

Publication Date

2020

Volume

3

Issue

4

Start / End Page

288 / 294

Location

United States

Related Subject Headings

  • Prostaglandins, Synthetic
  • Prospective Studies
  • Male
  • Intraocular Pressure
  • Humans
  • Glaucoma
  • Female
  • Eyelid Diseases
  • Eyelashes
  • Cross-Sectional Studies
 

Citation

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ICMJE
MLA
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Kim, J. S., Blizzard, S., Woodward, J. A., Leyngold, I. M., Liss, J., & Freedman, S. F. (2020). Prostaglandin-Associated Periorbitopathy in Children and Young Adults with Glaucoma. Ophthalmol Glaucoma, 3(4), 288–294. https://doi.org/10.1016/j.ogla.2020.03.009
Kim, Jane S., Sonya Blizzard, Julie A. Woodward, Ilya M. Leyngold, Jason Liss, and Sharon F. Freedman. “Prostaglandin-Associated Periorbitopathy in Children and Young Adults with Glaucoma.Ophthalmol Glaucoma 3, no. 4 (2020): 288–94. https://doi.org/10.1016/j.ogla.2020.03.009.
Kim JS, Blizzard S, Woodward JA, Leyngold IM, Liss J, Freedman SF. Prostaglandin-Associated Periorbitopathy in Children and Young Adults with Glaucoma. Ophthalmol Glaucoma. 2020;3(4):288–94.
Kim, Jane S., et al. “Prostaglandin-Associated Periorbitopathy in Children and Young Adults with Glaucoma.Ophthalmol Glaucoma, vol. 3, no. 4, 2020, pp. 288–94. Pubmed, doi:10.1016/j.ogla.2020.03.009.
Kim JS, Blizzard S, Woodward JA, Leyngold IM, Liss J, Freedman SF. Prostaglandin-Associated Periorbitopathy in Children and Young Adults with Glaucoma. Ophthalmol Glaucoma. 2020;3(4):288–294.
Journal cover image

Published In

Ophthalmol Glaucoma

DOI

EISSN

2589-4196

Publication Date

2020

Volume

3

Issue

4

Start / End Page

288 / 294

Location

United States

Related Subject Headings

  • Prostaglandins, Synthetic
  • Prospective Studies
  • Male
  • Intraocular Pressure
  • Humans
  • Glaucoma
  • Female
  • Eyelid Diseases
  • Eyelashes
  • Cross-Sectional Studies