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The effectiveness of latanoprost for the treatment of pediatric glaucoma
L B Enyedi1, S F Freedman, E G Buckley
1Department of Ophthalmology, Duke University, Durham, North Carolina, USA.
Insights
Latanoprost effectively lowers intraocular pressure in a minority of pediatric glaucoma patients. However, in selected children, it demonstrates significant ocular hypotensive effects and is well-tolerated.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Pharmacology
Background:
- Latanoprost, a prostaglandin F2alpha analogue, is a known effective treatment for reducing intraocular pressure (IOP) in adults with open-angle glaucoma.
- The efficacy and safety of latanoprost in pediatric populations with glaucoma remain largely uncharacterized.
Purpose of the Study:
- To evaluate the efficacy and safety of latanoprost therapy in children diagnosed with various forms of glaucoma.
- To determine the potential of latanoprost as an ocular hypotensive agent in pediatric glaucoma management.
Main Methods:
- A prospective study was conducted on pediatric patients receiving latanoprost between September 1996 and January 1998.
- Intraocular pressure (IOP) was monitored before and after latanoprost administration, with responders defined by a ≥15% IOP reduction.
- Side effects and iris color changes were systematically recorded during follow-up examinations.
Main Results:
- The study included 48 pediatric patients (57 eyes) with diverse glaucoma diagnoses; 31 eyes had interpretable IOP data.
- The overall mean IOP reduction was minimal (0.9%), with only 6 patients (6 eyes) identified as responders (average 34% IOP reduction).
- Responders were more likely to have juvenile open-angle glaucoma and be older; side effects were infrequent and mild, with no noticeable iris color changes.
Conclusions:
- Latanoprost is effective in a limited number of pediatric glaucoma cases, despite being well-tolerated.
- In specific pediatric patients, latanoprost can achieve significant IOP reduction, comparable to adult treatment outcomes.
- Further investigation into patient selection for latanoprost therapy in pediatric glaucoma is warranted.
Purpose:
Latanoprost is a prostaglandin F2alpha analogue that substantially reduces intraocular pressure (IOP) in adults with open-angle glaucoma or ocular hypertension. The efficacy and safety of latanoprost in children is unknown. We wished to evaluate latanoprost therapy for children with glaucoma.
Methods:
This was a prospective study of all patients who were given latanoprost at our institution between September 1996 and January 1998. The baseline IOP was compared with the postlatanoprost IOP for each patient, and side effects and any iris color change were noted at each follow-up examination. Responders were defined as those who had at least a 15% IOP reduction on latanoprost, whereas nonresponders showed less than a 15% IOP reduction on latanoprost.
Results:
Fifty-seven eyes of 48 pediatric patients with a variety of glaucoma diagnoses and an average age of 7.1 years were included in the study. Of these, 31 eyes of 31 patients had interpretable IOP data; the mean IOP reduction for this group after the addition of latanoprostwas 0.9% (0.2 mm Hg). Six patients (6 eyes) were responders, with an average IOP reduction of 8.5 mm Hg (34%), whereas the majority of patients (25) were nonresponders. In the responders, there was a good correlation (r = 0.9) between baseline IOP and the magnitude of IOP reduction. Responders were significantly more likely to have juvenile open-angle glaucoma and to be older than nonresponders. Systemic and ocular side effects were infrequent and mild, and no patient had noticeable iris color changes.
Conclusions:
When used in a group of pediatric patients with a variety of glaucoma diagnoses and on various therapies, latanoprost is effective in only a minority of cases. In selected patients, however, latanoprost shows an impressive ocular hypotensive effect, comparable with that obtained when this drug is used in adults with open-angle glaucoma. This drug appears to be well tolerated in this short-term study of pediatric patients with glaucoma.
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