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Periocular skin hyperpigmentation in children treated with prostaglandin analogues
Mohammed Al-Zobidi1, Rajiv Khandekar1, Earl Randy Craven2
1King Khaled Eye Specialist hospital, Riyadh, Saudi Arabia.
Insights
Prostaglandin analogue (PGA) use in children with glaucoma can cause periocular skin hyperpigmentation, particularly on the upper eyelids. This side effect was observed in all patients using PGAs for over six months.
Area of Science:
- Ophthalmology
- Pediatric Glaucoma Management
- Dermatology
Background:
- Glaucoma is a leading cause of irreversible blindness in children.
- Prostaglandin analogues (PGAs) are commonly used to manage pediatric glaucoma.
- Periocular skin hyperpigmentation is a known side effect of PGAs.
Purpose of the Study:
- To investigate and report periocular skin hyperpigmentation in children with glaucoma treated with prostaglandin analogues (PGAs).
- To quantify the extent and characteristics of hyperpigmentation associated with PGA use in pediatric patients.
Main Methods:
- A cross-sectional study involving 55 children treated with PGAs for at least six months.
- Objective measurement of pigmentation using a chromameter on eyelids and cheeks.
- Subjective grading of hyperpigmentation from photographs and parental perception.
Main Results:
- All patients exhibited hyperpigmentation of the upper and lower eyelids.
- The upper eyelids showed significantly more hyperpigmentation than the lower eyelids.
- No correlation was found between hyperpigmentation severity and age, baseline skin tone, PGA duration, type, or therapy regimen.
Conclusions:
- Periocular skin hyperpigmentation is a consistent finding in children using PGAs for glaucoma.
- Upper eyelid hyperpigmentation is more pronounced than lower eyelid hyperpigmentation.
- The study did not identify specific factors influencing the grade of hyperpigmentation beyond PGA use itself.
Purpose:
To report periocular skin hyperpigmentation related to prostaglandin analogue (PGA) use in children with glaucoma.
Methods:
This cross-sectional study examined children treated with PGA for at least 6 months between June 2013 and December 2013. The pigmentation scores of the upper eyelids, lower eyelids and cheek were recorded with a chromameter. Hyperpigmentation was defined as a positive difference in scores between the cheek and the upper/lower eyelid. The influence of age, baseline skin pigmentation, duration of PGA, type of PGA and mono- or multitherapy on hyperpigmentation were evaluated. Subjective grading of pigmentation on standardized face photographs and the parent's perception of hyperpigmentation were also recorded. A P value of <0.05 was considered significant.
Result:
A total of 55 patients were included. Hyperpigmentation of the upper and lower eyelids occurred in all eyes. Subjectively, 26 (47%) eyes had mild and 14 (26%) moderate hyperpigmentation. The upper eyelid showed significantly greater hyperpigmentation than the lower eyelid (P = 0.00004). Chromameter measurements overlapped with pigmentation grading on photographs. The type of and duration of PGA use, PGA mono- or multidrug therapy or baseline skin pigmentation had no effect on the grade of hyperpigmentation.
Conclusions:
PGA use for more than 6 months was associated with periocular skin hyperpigmentation that was greater in the upper eyelid versus lower eyelid. All variables examined failed to show a relationship with the grade of hyperpigmentation.
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