The Role Of Nitric Oxide In Enhancing Iop Reduction And Its Impact On Ocular Surface Health: Insights From Latanoprostene Bunod
Published 2025 - 43rd Congress of the ESCRS
Reference: FP27.02 | Type: Free paper | DOI: 10.82333/rd0e-5y80
Authors: Catherine Drew* 1 , Stephen Stewart 1 , Niraj Mandal 1 , Richard McNeely 1 , Jonathan Moore 1
1Cathedral Eye Clinic,Belfast,United Kingdom
Purpose
To evaluate the IOP lowering efficacy, ocular surface effects, and early-phase conjunctival hyperemia of latanoprostene bunod ophthalmic solution in treatment-naïve glaucoma and ocular hypertension patients. This study specifically aimed to assess whether the nitric oxide (NO) component causes additional ocular hyperemia and to compare IOP reduction between patients with higher versus lower baseline IOP.
Setting
Single tertiary eye care center
Methods
This prospective study included 44 eyes from 44 treatment-naïve patients diagnosed with primary open-angle glaucoma, pseudoexfoliation glaucoma, or high-risk ocular hypertension. Comprehensive baseline ophthalmic examinations included IOP measurement using Goldmann applanation tonometry, tear film breakup time (TFBUT), Schirmer II test, Oxford scale grading of ocular surface staining, and Ocular Surface Disease Index (OSDI) questionnaire. Biomicroscopic photographs were taken before and at 3, 5, and 10 minutes after initial latanoprostene bunod application to assess for NO-induced conjunctival hyperemia. Follow-up examinations were conducted at 1, 3, and 6 months.
Results
Mean age was 64.4±7.81 years (19 females, 25 males). Four patients discontinued treatment. Baseline IOP of 25.91±5.19mmHg decreased to 16.63±2.92mmHg (35.82%), 16.64±2.43mmHg (35.78%), and 16.27±2.56mmHg (37.21%) at 1, 3, and 6 months (p<0.001). Patients with higher baseline IOP showed greater reduction (40-42% vs 17-21%), with final IOPs converging around 16mmHg. Ocular surface parameters showed minimal clinical changes. Only one patient exhibited NO-mediated hyperemia.
Conclusions
Latanoprostene bunod demonstrated significant IOP-lowering efficacy over 6 months, comparable to previous trials. IOP reduction depended on baseline values, with final IOPs stabilizing around 16 mmHg. Concerns about NO-induced conjunctival hyperemia were largely unfounded. Changes in ocular surface parameters, while statistically significant, were clinically insignificant. Latanoprostene bunod appears effective with a favorable ocular profile for treatment-naïve glaucoma patients.