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Reticular Bullous Epithelial Edema in Corneas Treated with Netarsudil: A Case Series.

C Ellis Wisely¹, Katy C Liu¹, Divakar Gupta¹

¹Cornea and External Disease Division, Refractive Surgery Service, Duke University Eye Center, Duke University School of Medicine, Durham, North Carolina, USA.

American Journal of Ophthalmology

|April 15, 2020

Summary

Netarsudil treatment can cause a specific pattern of bullous epithelial corneal edema. Discontinuing netarsudil led to improvement in corneal edema and visual acuity in all patients studied.

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Area of Science:

Ophthalmology
Corneal Disease
Pharmacology

Background:

Netarsudil is a Rho kinase inhibitor used to treat glaucoma.
Unusual patterns of corneal edema have been reported with ocular medications.

Observation:

A reticular pattern of bullous epithelial corneal edema was observed in patients treated with netarsudil.
Most patients had a history of corneal edema or risk factors for it.

Findings:

Six episodes of this specific corneal edema occurred in 5 patients receiving netarsudil.
Visual acuity worsened in most cases with edema onset but improved after netarsudil discontinuation.
Corneal edema resolved in all cases upon stopping netarsudil.

Implications:

Netarsudil may induce a characteristic bullous epithelial corneal edema, particularly in susceptible individuals.
Discontinuation of netarsudil is effective in resolving this adverse event.
Ophthalmologists should be aware of this potential side effect when prescribing netarsudil.