Cystoid macular edema associated with latanoprost therapy in a case seriesof patients with glaucoma and ocular hypertension

Objective: To identify coexisting ocular diagnoses in a case series of eyes that developed cystoid macular edema (CME) associated with latanoprost the rapy. Design: Retrospective observational case series. Participants: Seven eyes of seven patients who developed CME possibly assoc iated with latanoprost treatment were studied. Intervention: When these patients, all of whom were treated with latanopros t in addition to other glaucoma medications, described blurred vision or ey e irritation, ocular examination revealed CME, which was confirmed by fluor escein angiography. Latanoprost was discontinued, and in three cases topica l corticosteroids and nonsteroidal anti-inflammatory agents were used to tr eat the CME, Main Outcome Measures: Visual acuity and intraocular pressure were determin ed before latanoprost use began, during therapy, and after latanoprost use ceased, In these cases, resolution of CME was documented clinically after d iscontinuing latanoprost. Results: Clinically significant CME developed after 1 to 11 months of latan oprost treatment, with an average decrease of 3 lines in Snellen visual acu ity, Intraocular pressure decreased an average of 27.9% during treatment. C ystoid macular edema was confirmed in all cases by fluorescein angiography. In these seven patients, the following coexisting ocular conditions may ha ve placed these eyes at risk for prostaglandin-mediated blood-retinal barri er vascular insufficiency: history of dipivefrin-associated CME, epiretinal membrane, complicated cataract surgery, history of macular edema associate d with branch retinal vein occlusion, history of anterior uveitis, and diab etes mellitus, In all cases, the macular edema resolved following discontin uation of latanoprost, in some instances with concomitant use of steroidal and nonsteroidal anti-inflammatory agents. Conclusions: In this case series of pseudophakic, aphakic, or phakic eyes, the temporal relationships between the use of latanoprost and developing CM E, and the resolution of CME following cessation of the drug, suggest an as sociation between latanoprost and CME, In all cases, coexisting ocular cond itions associated with an altered blood-retinal barrier were present.