Effects of ripasudil, a rho kinase inhibitor, on blood flow in the optic nerve head of normal rats

Wada, Yasushi; Higashide, Tomomi; Nagata, Atsushi; Sugiyama, Kazuhisa

doi:10.1007/s00417-018-4191-6

Cited by 8 publications

(4 citation statements)

References 39 publications

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“…In this case, the patient was given an antiplatelet tablet and ripasudil eye drops. The antiplatelet is known to increase pulsatile ocular blood flow among those with diabetic retinopathy [24]; ripasudil has also been reported to increase ONH blood flow in the eyes of normal rats [25,26]. The level of the HbA1C and cholesterol reduced several months after the initial visit.…”

Section: Discussionmentioning

confidence: 99%

Time Course in Ocular Blood Flow and Pulse Waveform in a Case of Ocular Ischemic Syndrome with Intraocular Pressure Fluctuation

Yamazaki

Hashimoto

Masahara

et al. 2020

Vision

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We report on a 70-year-old Japanese man with complaints of worsening left visual acuity who was diagnosed with ocular ischemic syndrome (OIS) associated with internal carotid artery (ICA) stenosis. A gonioscopy examination showed rubeosis iridis and elevated intraocular pressure (IOP) in the left eye (50 mmHg) at the baseline visit. The optic nerve head (ONH) and choroidal blood flow measured by laser speckle flowgraphy (LSFG) was impaired in the left eye compared with that in the right eye. Additionally, the blowout score (BOS), which indicates the variation of the mean blur rate (MBR) during systolic and diastolic periods, was decreased in the left eye. After treatment with an injection of bevacizumab and administration of Rho-associated kinase-inhibitor ripasudil eye drops, both ocular blood flow and BOS in each vascular bed gradually increased along with IOP reduction. The visual acuity also improved. The current case demonstrated increased blood flow and decreased fluctuation of blood flow in the ONH and choroid before and after the treatment in OIS with rubeosis iridis. The LSFG technique is useful to non-invasively assess the ocular circulation and pulse waveform in OIS.

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Section: Discussionmentioning

confidence: 99%

Time Course in Ocular Blood Flow and Pulse Waveform in a Case of Ocular Ischemic Syndrome with Intraocular Pressure Fluctuation

Yamazaki

Hashimoto

Masahara

et al. 2020

Vision

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“…Rho kinase (ROCK) inhibitors not only lower IOP via decreased aqueous outflow resistance, but also enhance axonal regeneration and increase ocular blood flow in animal models [126][127][128]. There are currently clinical trials investigating retinal blood vessel density as well as retinal and episcleral blood flow in patients receiving topical Netarsudil, but the results have yet to be published (NCT04064918, NCT04401982).…”

Section: Vascular Therapiesmentioning

confidence: 99%

Future directions of glaucoma treatment: emerging gene, neuroprotection, nanomedicine, stem cell, and vascular therapies

Ciociola,

Fernandez,

Kaufmann

et al. 2023

Current Opinion in Ophthalmology

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Purpose of review The aim of this article is to summarize current research on novel gene, stem cell, neuroprotective, nanomedicine, and vascular therapies for glaucoma. Recent findings Gene therapy using viral vectors and siRNA have been shown to reduce intraocular pressure by altering outflow and production of aqueous humor, to reduce postsurgical fibrosis with few adverse effects, and to increase retinal ganglion cell (RGC) survival in animal studies. Stem cells may treat glaucoma by replacing or stimulating proliferation of trabecular meshwork cells, thus restoring outflow facility. Stem cells can also serve a neuroprotective effect by differentiating into RGCs or preventing RGC loss via secretion of growth factors. Other developing neuroprotective glaucoma treatments which can prevent RGC death include nicotinamide, the NT-501 implant which secretes ciliary neurotrophic factor, and a Fas-L inhibitor which are now being tested in clinical trials. Recent studies on vascular therapy for glaucoma have focused on the ability of Rho Kinase inhibitors and dronabinol to increase ocular blood flow. Summary Many novel stem cell, gene, neuroprotective, nanomedicine, and vascular therapies have shown promise in preclinical studies, but further clinical trials are needed to demonstrate safety and efficacy in human glaucomatous eyes. Although likely many years off, future glaucoma therapy may take a multifaceted approach.

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“…Administration of ROCK inhibitors has been shown to enhance ocular blood flow in both normal and disease rabbit models, as well as in normal rat models. This was demonstrated by increased blood flow in the optic nerve head when assessed using LASER speckle flowgraphy [8,15]. ROCK inhibitors administration induces the relaxation of vascular smooth muscle cells, leading to the dilation of ONH blood vessels.…”

Section: The Rho Kinase Pathwaymentioning

confidence: 99%

ROCK Inhibitors in Corneal Diseases and Glaucoma—A Comprehensive Review of These Emerging Drugs

Pagano,

Lee,

Posarelli

et al. 2023

JCM

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Rho kinase (ROCK) inhibitors have gained significant attention as emerging novel treatment options in the field of ophthalmology in recent years. The evidence supporting their efficacy in glaucoma and corneal pathology includes both in vitro and clinical studies. Among the available options, ripasudil and netarsudil have emerged as the leading ROCK inhibitors, and some countries have approved these therapeutic options as treatments for glaucoma. Various dosing regimens have been studied, including monotherapy and combination therapy, especially for patients with secondary glaucoma who are already on multiple medications. Another rising application of ROCK inhibitors includes their use as an adjunct in surgical procedures such as Descemetorhexis Without Endothelial Keratoplasty (DWEK), Descemet Stripping Only (DSO) to accelerate visual recovery, glaucoma surgeries to reduce scarring process and allow better intraocular pressure (IOP) control, or after complicated anterior segment surgery to treat corneal oedema. This article provides a comprehensive overview of the existing literature in the field, offering recommendations for prescribing ROCK inhibitors and also discussing patient selection, drug efficacy, and possible adverse effects.

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Effects of ripasudil, a rho kinase inhibitor, on blood flow in the optic nerve head of normal rats

Cited by 8 publications

References 39 publications

Time Course in Ocular Blood Flow and Pulse Waveform in a Case of Ocular Ischemic Syndrome with Intraocular Pressure Fluctuation

Time Course in Ocular Blood Flow and Pulse Waveform in a Case of Ocular Ischemic Syndrome with Intraocular Pressure Fluctuation

Future directions of glaucoma treatment: emerging gene, neuroprotection, nanomedicine, stem cell, and vascular therapies

ROCK Inhibitors in Corneal Diseases and Glaucoma—A Comprehensive Review of These Emerging Drugs

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