title: Reversible Conjunctival Pigmentation Associated With Prostaglandin Use.
abstract: A 54-year-old Indian male with a diagnosis of ocular hypertension was started on a prostaglandin analog (PGA) in both eyes to lower intraocular pressure. Six years later, he developed progressively increasing bilateral limbal conjunctival hyperpigmentation. Travoprost was discontinued and replaced with brinzolamide and over the next year, the patient's conjunctival pigmentation improved significantly in both the eyes. This case report documents with slit-lamp photography the first case of conjunctival pigmentation associated with PGA use that has been shown to have reversal with discontinuation of the PGA. Because of the widespread use of PGAs, and the evolving nature of the conjunctival pigmentation, clinicians should be aware of this reversible condition when considering biopsy or removal of conjunctival melanocytic lesions.
authors.affiliation: *Department of Ophthalmology, Byers Eye Institute, Stanford University †Mid-Peninsula Ophthalmology Medical Group, Palo Alto, CA.
authors.forename: Daniel Y
authors.initials: DY
authors.lastname: Choi
authors.forename: Robert T
authors.initials: RT
authors.lastname: Chang
authors.forename: Krishnan
authors.initials: K
authors.lastname: Yegnashankaran
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Friedman
mesh_terms: D000959:Antihypertensive Agents / Q000009:adverse effects*; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use; D003229:Conjunctival Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D057915:Drug Substitution; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D013449:Sulfonamides / Q000627:therapeutic use; D013843:Thiazines / Q000627:therapeutic use; D014065:Tonometry, Ocular; D000069557:Travoprost / Q000009:adverse effects*
chemical_list: D000959:Antihypertensive Agents; D002257:Carbonic Anhydrase Inhibitors; D013449:Sulfonamides; D013843:Thiazines; C111827:brinzolamide; D000069557:Travoprost