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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...

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Reversible Corneal Endothelial Abnormalities With Netarsudil.

Angelo P Tanna¹, Hamed Esfandiari, Kyla Teramoto

¹Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL.

Journal of Glaucoma

|April 1, 2020

Summary

Topical netarsudil treatment can cause reversible corneal endothelial abnormalities, presenting as blurred vision and guttata-like changes. These effects resolved after discontinuing netarsudil, highlighting a potential side effect for ophthalmologists to monitor.

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Area of Science:

Ophthalmology
Corneal Science
Pharmacology

Background:

A case study investigating corneal endothelial changes associated with topical glaucoma medication.
Focus on the fixed-dose combination of netarsudil and latanoprost in managing primary open-angle glaucoma.

Observation:

A 68-year-old woman experienced blurred vision after initiating fixed-dose combination netarsudil-latanoprost.
Slit-lamp examination revealed guttata-like corneal endothelial abnormalities in both eyes.
Specular microscopy showed irregular corneal endothelial cells with indistinct borders.

Findings:

Discontinuation of netarsudil in one eye led to resolution of corneal endothelial abnormalities and improved visual acuity.
Continued netarsudil treatment in the other eye showed no change in endothelial abnormalities.
Corneal endothelial changes associated with netarsudil appear to be transient and reversible.

Implications:

Topical netarsudil may induce reversible corneal endothelial cell abnormalities.
Specular microscopy is a valuable tool for detecting these drug-induced changes.
Ophthalmologists should consider netarsudil-induced corneal toxicity in patients presenting with blurred vision.