Clinical course of bimatoprost-induced periocular skin changes in Caucasians

To describe the demographic and clinical characteristics of bimatoprost-induced periocular skin hyperpigmentation in Caucasians.

Retrospective noncomparative case series.

Thirty-seven Caucasian patients (29 female, 8 male) with a diagnosis of primary open-angle glaucoma (n = 28) or ocular hypertension (n = 9) in whom cosmetically noticeable periocular skin pigmentation developed with bimatoprost therapy.

An unbiased examiner performed a retrospective chart analysis of patients in whom periocular skin hyperpigmentation developed after starting bimatoprost therapy. Data collected included patient demographics, diagnosis, medication history, dates of starting and stopping bimatoprost treatment, and subjective assessment of the periocular hyperpigmentation at initial detection and follow-up visits.

Periocular hyperpigmentation was graded using an arbitrary scale from 0 to 3. The number of days to the onset of hyperpigmentation and to pigment resolution was determined and their associations to demographic and other clinical parameters were analyzed.

Patients had variable grades of periocular hyperpigmentation at presentation (mean, 1.27+/-0.50; range, 1-2.5). Bimatoprost-induced periocular hyperpigmentation appeared most frequently between 3 and 6 months after initiation of bimatoprost therapy (277+/-138 days). Resolution of skin hyperpigmentation was noted most frequently between 3 and 12 months (205+/-97 days); however, there was a wide range of 61 to 472 days. Thirty-three of the 37 patients had complete resolution of the periocular hyperpigmentation.

Bimatoprost use is associated with periocular skin hyperpigmentation in Caucasians with variable time of onset. The periocular hyperpigmentation appears gradually, but in this series was completely reversible on discontinuation of bimatoprost.