As a contraindication to prostaglandin analogs, which condition is listed?

• A. Active intraocular inflammation
• B. Previous episodes of herpes simplex keratitis
• C. CME or risk for CME
• D. Bone issues

Answer: (C)

Prostaglandin analogs can promote cystoid macular edema by increasing vascular permeability in the retina, which disrupts the blood-retinal barrier. Because of this, CME or a risk for CME is a listed contraindication to using these medications. This risk is especially relevant in eyes with a history of macular edema, recent cataract surgery (Irvine-Gass syndrome), diabetes, or other retinal conditions that predispose to edema, so those patients are generally not ideal candidates for prostaglandin analog therapy.

Active intraocular inflammation and prior herpes simplex keratitis are considerations to note and may warrant caution, but they are not the primary contraindication in the same way CME is. Bone issues are unrelated to the use of prostaglandin analogs.