Exploring the impact of latanoprostene bunod versus latanoprost on optic disc, macular, and choroidal vasculature: A comparative analysis

PURPOSE: This study aims to compare the effect of latanoprostene bunod and latanoprost on the vasculature of the posterior segment of the eye.
METHODS: The study included 34 eyes of 17 patients diagnosed with primary open-angle glaucoma or ocular hypertension. Of these, 14 eyes of 7 patients were administered latanoprost 0.005% (Latafree, VEM ilaç, Türkiye) once daily (defined as the LAT group), while 20 eyes of 10 patients were administered latanoprostene bunod 0.024% (Vyzulta, Bausch+Lomb, Rochester, NY, USA) once daily (defined as the VYZ group). Intraocular pressure (IOP), macular and optic disc vascular density (VD), as well as submacular and subfoveal choroidal vascular parameters, were assessed for changes within each group over time and compared between groups at all time points (at baseline, month 1, month 3, and month 6).
RESULTS: Latanoprost demonstrated superiority in reducing IOP compared to latanoprostene bunod (p<0.001). Nevertheless, a substantial decrease in IOP was observed in both agents by the conclusion of the 6th month, in comparison with the initial baseline level (all p<0.001). At the 6th month, peripapillary VD was observed to be higher in the VYZ group (p=0.001), whereas the majority of macular VD or choroidal vascular parameters exhibited higher values in the LAT group.
CONCLUSION: Latanoprostene bunod may protect the optic nerve head from hypoperfusion-related damage by improving peripapillary vascular perfusion. IOP-lowering effect may be more pronounced with latanoprost, but both drugs can effectively lower IOP. In addition, the utilization of latanoprost may increase macular and choroidal vasculature.

Keywords: Choroidal vascularity index, Latanoprost, Latanoprostene bunod, Macular vascular density.