Background: The aim of this study is to report an adverse systemic response associated with topical bimatoprost therapy.
Case report: An otherwise healthy 58-year-old woman with primary open-angle glaucoma was started on bimatoprost drops once a day. Bimatoprost is a structural analog of prostaglandin F2 alpha-ethanolamide (PGF2a), a class of compounds that in systemic form has been associated with alterations in serum lipid levels. The patient subsequently experienced a significant decrease in her high-density lipoprotein (HDL) serum levels, which subsequently returned to normal on discontinuation of bimatoprost.
Conclusions: This is the first published report of a possible association between topical bimatoprost therapy and decreased serum HDL levels. Because of the significantly increased risk of cardiovascular disease and morbidity associated with low HDL levels, further study is strongly indicated.