The effectiveness of latanoprost for the treatment of pediatric glaucoma

Purpose: Latanoprest is a prostaglandin F-2 alpha analogue that substantial ly red ces 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 thera py for children with glau coma. 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, a nd side effects and any iris color change were noted at each follow-up exam ination. Responders were defined as those who had at least a 15% IOP reduct ion on latanoprost, whereas nonresponders showed less than a 15% IOP reduct ion 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 includ ed in the study. Of these, 31 eyes of 31 patients had interpretable IOP dat a; the mean IOP reduction for this group after the addition of latanoprost was 0.9% (0.2 mm Hg). Six patients (6 eyes) were responders, with an averag e IOP reduction of 8.5 mm Hg (34%), whereas the majority of patients (25) w ere 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 ol der than nonresponders. Systemic and ocular side effects were infrequent an d 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 c ases. In selected patients, however, latanoprost shows an impressive ocular hypotensive effect, comparable with that obtained when this drug is used i n adults with open-angle glaucoma. This drug appears to be well tolerated i n this short-term study of pediatric patients with glaucoma.