Mild-to-moderate changes in the ocular adnexa can occur in children and young adults with glaucoma following long-term unilateral prostaglandin analog (PGA) exposure, a recent study suggests.

This prospective, cross-sectional cohort study evaluated 29 patients with a history of childhood glaucoma who were treated unilaterally with PGAs for at least 12 months. Based on four standardized clinical photographs (en face with eyes open, right and left side views with eyes open and en face with eyes closed), three masked graders each independently selected the eye they thought had received unilateral PGA treatment and graded its ocular, palpebral and periorbital features relative to the other eye.

The team found that the median unilateral PGA exposure time was 31.7 months. They noted that eyelash trichomegaly and hypertrichosis, high upper eyelid crease, upper eyelid ptosis and superior sulcus hollowing were the most frequently observed features of PGA-associated periorbitopathy (PAP) in treated eyes. While most cases were mild, the investigators added that 20% to 30% of patients exhibited moderate eyelash or eyelid changes and one had severe PGA-associated periorbitopathy following long-term unilateral PGA exposure.

“Patients and their families should be educated on the possibility of PAP, especially when initiating monocular PGA therapy,” the study authors concluded in their paper.