Latanoprost is a
prostaglandin F2-alpha isopropyl
ester prodrug which is rapidly hydrolyzed by
esterases in the cornea to the biologically active
latanoprost acid. When
latanoprost is topically administered into the eye, the cornea seems to act like as a slow-release depot to the anterior segment. One hour after administration maximum concentration is found in the iris, followed by the anterior chamber and the ciliary body. Despite extensive research, controversy remains about the real mechanism of action of this drug. Immunohistochemical data have shown that the intraocular pressure (IOP) reduction with topical
prostaglandin F2-alpha is associated with a reduction of
collagens within the uveoscleral outflow pathway. Evidence from several experimental and clinical studies suggests that
latanoprost is a valuable addition first-line treatment alternatives for
glaucoma,
ocular hypertension and even
angle-closure glaucoma. Strong points are its efficacy, which is demonstrated to be higher than that of
brimonidine,
dorzolamide and
timolol with fewer systemic adverse effects; a convenient administration schedule; and the IOP-controlling pattern, which is relatively flat compared with
timolol and
dorzolamide, and enables better control in
glaucoma progression, since large fluctuations may be associated with the risk of developing
glaucoma in untreated ocular hypertensive subjects.