Latanoprostene Bunod Improves Blood Volume, Oxygen Saturation in Optic Nerve Head

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The study’s findings may cause clinicians to rethink the general concept that nitric oxide possesses neurotoxic properties.

Latanoprostene bunod 0.024% yields a significant increase in optic nerve head capillary blood volume (ONHvol) and oxygen saturation (ONHSa02) in healthy participants when compared with latanoprost 0.005%, according to a study published in Optometry and Vision Science. 

Researchers included 23 healthy participants (age range 21 to 62 years, 60% women) in a prospective double-blind crossover study to determine the effect of topical latanoprostene bunod 0.024% on ONHSa02 and ONHvol. The investigators obtained baseline measurements of ONHvol andONHSaO2 over the course of 2 hours via multichannel spectroscopic reflectometry. They repeated measurements following a 7-day, once-daily instillation regimen consisting of either latanoprost 0.005% or latanoprostene bunod 0.024%. The team crossed participants over to the alternate treatment following a 30-day washout period and reassessed measurements, all while blind to the method of treatment. 

The investigators noted a 4% increase in ONHSaO2 when using latanoprostene bunod 0.024% compared with latanoprost 0.005% (P <.001).  The former agent also boosted ONHvol by greater than twofold when assessed at 60, 80, and 120 minute intervals (P <.001).

“These results may contradict the general concept that nitric oxide possesses neurotoxic properties, particularly in regard to glaucomatous optic neuropathy, be it causative or resulting of the optic neuropathy,” according to the researchers. The team acknowledges that despite numerous studies analyzing the effects of nitric acid on the retina, “outcomes remain uncertain.”

Limitations of the study include a small sample size, the inclusion of only healthy patients, and the inability to determine whether participants complied with instructions regarding smoking, exercise, or caffeine intake.


Samaha D, Diaconu V, Bouchard JF, Desalliers C, Dupont A. Effect of latanoprostene bunod on optic nerve head blood flow. Optom Vis Sci. 2022;99(2):172-176. doi:10.1097/OPX.0000000000001842