title: [Orbital fat atrophy in glaucoma patients treated with topical bimatoprost--can bimatoprost cause enophthalmos?].
abstract: OBJECTIVE
  The aim of this communication is to report enophthalmos as a possible new adverse effect of topical bimatoprost treatment.
  
  
  METHODS
  A retrospective case series of five glaucoma patients under long-term topical bimatoprost treatment was evaluated. Documentation with photo and Hertel exophthalmometry was reviewed.
  
  
  RESULTS
  In all five patients a deep lid sulcus, reduced infraocular fat pads and enophthalmos-suspicious Hertel values were found (mean 11.9 mm; SD 2.4). Other aetiologies for enophthalmos were excluded anamnestically and by clinical examination.
  
  
  CONCLUSIONS
  Bimatoprost may lead to an alteration of the eyelid with deepening of the lid sulcus and may also be responsible for an iatrogenic orbital fat atrophy. A possible mechanism of action might be the induction of apoptosis of orbital fibroblasts with a remodelling of the extracellular matrix. Prospective studies are necessary to confirm this cross-sectional observation.
authors.affiliation: Klinik und Poliklinik für Augenheilkunde, Inselspital, Universität Bern, Schweiz. christoph.tappeiner@insel.ch
authors.forename: C
authors.initials: C
authors.lastname: Tappeiner
authors.forename: B
authors.initials: B
authors.lastname: Perren
authors.forename: M E
authors.initials: ME
authors.lastname: Iliev
authors.forename: B E
authors.initials: BE
authors.lastname: Frueh
authors.forename: D
authors.initials: D
authors.lastname: Goldblum
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects* / Q000473:pathology*; D000287:Administration, Topical; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage* / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects; D001284:Atrophy / Q000139:chemically induced / Q000175:diagnosis; D000069580:Bimatoprost; D003008:Cloprostenol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D015841:Enophthalmos / Q000139:chemically induced* / Q000175:diagnosis*; D005123:Eye / Q000187:drug effects* / Q000473:pathology*; D005260:Female; D005901:Glaucoma / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male
chemical_list: D000577:Amides; D000959:Antihypertensive Agents; D003008:Cloprostenol; D000069580:Bimatoprost