Angina Pectoris Following Latanoprostene Bunod 0.024% Administration: A Case Report

Latanoprostene bunod 0.024% is a nitric oxide-donating prostaglandin analog approved for lowering intraocular pressure in patients with open-angle glaucoma and ocular hypertension. Although generally considered safe, systemic adverse effects are rarely reported. We are reporting a case of a 63-year-old healthy Asian male with newly diagnosed normal-tension glaucoma who was prescribed latanoprostene bunod ophthalmic drops, which resulted in him experiencing angina pectoris. On the day of initiation, he experienced throat dryness and heartburn, followed by a sudden episode of intense retrosternal constricting chest pain during the night. A comprehensive cardiological evaluation-including electrocardiography (ECG), cardiac biomarkers, echocardiography, and stress testing-revealed no abnormalities. Notably, the patient's chest pain resolved completely within 12 hours of discontinuing the eye drops. Although prostaglandin analogs such as latanoprostene bunod are primarily believed to exert localized ocular effects, they may cause systemic reactions through mechanisms including vasoconstriction and nociceptor sensitization-particularly in susceptible individuals. This case underscores the importance of clinical vigilance for atypical systemic symptoms following initiation of topical glaucoma medications and supports the need for further investigation into their cardiovascular safety profile.