The Effect of Latanoprost and Brimonidine on Rabbit Subconjunctival Fibroblasts

Purpose: Subconjunctival fibroblasts play a critical role in scarring and treatment failure in fistulizing surgery for glaucoma. The proliferation of subconjunctival fibroblasts appears to be modulated by topical glaucoma medications. This study was conducted to evaluate the effects of latanoprost and brimonidine on subconjunctival fibroblast proliferation in rabbit eyes. Methods: Twelve pigmented Dutch-belted rabbits were divided into treatment groups of four: latanoprost 0.005%, brimonidine 0.2%, or balanced saline solution (BSS) each were administered to one treatment group, both eyes of each rabbit, twice a day, 6 days a week for 10 weeks. The eyes were then enucleated along with the conjunctiva, fixed, processed, and evaluated by light microscopy and immunohistochemistry using anti-proliferating cell nuclear antigen (PCNA) and anti-muscle-specific actin antibody (HHF-35). Fibroblast cell counts were performed at magnification x40. Results: In all groups, few inflammatory cells were seen in the subconjunctival space under light microscopy. PCNA staining revealed a statistically significant increase in the mean number of labeled fibroblasts in the group receiving brimonidine compared with the control (BSS) group. The group receiving latanoprost also had a significantly higher mean number of labeled fibroblasts than the groups receiving brimonidine or BSS. Only a few fibroblasts stained positively with the anti HHF antibody. Eyes treated with latanoprost, however, had significantly higher numbers of positively labeled cells than eyes treated with brimonidine or BSS. Conclusion: When applied to rabbit eyes, latanoprost and brimonidine appear to increase the number of positively labeled proliferating subconjunctival fibroblasts.