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