Reticular epithelial corneal edema as a novel side-effect of Rho Kinase Inhibitors: An Indian scenario

Bhargava, Mona; Sen, Surajit; Bhambhani, Varsha; Paul, Raj S; Dutta, Chandana

doi:10.4103/ijo.ijo_2865_21

Cited by 16 publications

(11 citation statements)

References 29 publications

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“…Previous reports have documented the clinical and OCT findings of honeycomb epithelial oedema. The role of OCT has also been outlined by other authors to differentiate between stromal oedema either occurring due to allograft rejection or because of decompensation 10 11. But none of the earlier reports have described the histopathological findings and this report is the first to do so.…”

Section: Discussionmentioning

confidence: 62%

Honeycomb epithelial oedema due to ripasudil: clinical, optical coherence tomography and histopathological correlation

Jain

Singh²,

Mishra

et al. 2022

BMJ Case Rep

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A male in his 50s, who had undergone Descemet’s stripping automated endothelial keratoplasty (DSAEK) for corneal oedema following irido-corneal-endothelial syndrome and glaucoma drainage device surgery for secondary glaucoma presented with gradual decreased vision. The patient was on ripasudil 0.4% for the past 4 months prior to the presentation. Honeycomb epithelial oedema was seen with vesicles and intraepithelial microcyst formation which were also noted on anterior segment optical coherence tomography (OCT) and histopathology, that co-related with the slit-lamp findings. The patient underwent repeat DSAEK and had a good outcome. While the clinical features and OCT findings have been reported earlier, the histopathological features have not been reported.

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Section: Discussionmentioning

confidence: 62%

Honeycomb epithelial oedema due to ripasudil: clinical, optical coherence tomography and histopathological correlation

Jain

Singh²,

Mishra

et al. 2022

BMJ Case Rep

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“…A systematic review of 10 studies showed that the most common ocular surface damage caused by Rho kinase inhibitors was conjunctival congestion (19-65%), followed by conjunctival hemorrhage (6-20%) and corneal rotavirus (13-26%) [81]. Bhargava et al also found that netarsudil and ripasudil may result in reticular epithelial corneal edema [82]. However, only 12 eyes were included in this study.…”

Section: Effects Of Rho Kinase Inhibitors On Ocular Surfacementioning

confidence: 86%

A Narrative Review of Ocular Surface Disease Related to Anti-Glaucomatous Medications

et al. 2022

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Topical anti-glaucomatous medications are still the most important measure to lower intraocular pressure. Large number of studies have confirmed that long-term use of anti-glaucomatous eye drops, especially containing benzalkonium chloride, a preservative, can cause or aggravate ocular surface injury. Ocular surface diseases damage the ocular microenvironmental health status, reduce the patients' compliance with the treatment, and finally affect the treatment result. Therefore, the ocular surface management of patients with glaucoma is very important. This includes the selection of drugs that are better tolerated according to individual conditions, preservative-free formulations, drugs that protect against ocular surface disease, or selecting surgery and laser treatment, to prevent the damage to the ocular surface by topical anti-glaucomatous drugs.

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“…So far only in case series reticular bullous epithelial edema has been observed with netarsudil use, which resolved after discontinuation. 90 , 91 …”

Section: Rock Inhibitors As Potential Therapeutics For Corneal Diseasesmentioning

confidence: 99%

The Role of Rho Kinase Inhibitors in Corneal Diseases

Futterknecht,

Chatzimichail,

Gugleta

et al. 2024

DDDT

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The cornea, as the outermost layer of the eye, plays a crucial role in vision by focusing light onto the retina. Various diseases and injuries can compromise its clarity, leading to impaired vision. This review aims to provide a thorough overview of the pharmacological properties, therapeutic potential and associated risks of Rho-associated protein kinase (ROCK) inhibitors in the management of corneal diseases. The article focuses on four key ROCK inhibitors: Y-27632, fasudil, ripasudil, and netarsudil, providing a comparative examination. Studies supporting the use of ROCK inhibitors highlight their efficacy across diverse corneal conditions. In Fuchs’ endothelial corneal dystrophy, studies on the application of Y-27632, ripasudil, and netarsudil demonstrated noteworthy enhancements in corneal clarity, endothelial cell density, and visual acuity. In pseudophakic bullous keratopathy, the injection of Y-27632 together with cultured corneal endothelial cells into the anterior chamber lead to enhanced corneal endothelial cell density and improved visual acuity. Animal models simulating chemical injury to the cornea showed a reduction of neovascularization and epithelial defects after application of fasudil and in a case of iridocorneal endothelial syndrome netarsudil improved corneal edema. Addressing safety considerations, netarsudil and ripasudil, both clinically approved, exhibit adverse events such as conjunctival hyperemia, conjunctival hemorrhage, cornea verticillata, conjunctivitis, and blepharitis. Monitoring patients during treatment becomes crucial to balancing the potential therapeutic benefits with these associated risks. In conclusion, ROCK inhibitors, particularly netarsudil and ripasudil, offer promise in managing corneal diseases. The comparative analysis of their pharmacological properties and studies supporting their efficacy underscore their potential therapeutic significance. However, ongoing research is paramount to comprehensively understand their safety profiles and long-term outcomes in diverse corneal conditions, guiding their optimal application in clinical practice.

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Reticular epithelial corneal edema as a novel side-effect of Rho Kinase Inhibitors: An Indian scenario

Cited by 16 publications

References 29 publications

Honeycomb epithelial oedema due to ripasudil: clinical, optical coherence tomography and histopathological correlation

Honeycomb epithelial oedema due to ripasudil: clinical, optical coherence tomography and histopathological correlation

A Narrative Review of Ocular Surface Disease Related to Anti-Glaucomatous Medications

The Role of Rho Kinase Inhibitors in Corneal Diseases

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