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Reticular epithelial corneal edema as a novel side-effect of Rho Kinase Inhibitors: An Indian scenario
Mona Bhargava1, Surajit Sen2, Varsha Bhambhani1
1Department of Cornea and Ocular Surface, Aditya Birla Sankara Nethralaya, Kolkata, West Bengal (A Unit of Medical Research Foundation, Chennai), India.
Indian Journal of Ophthalmology
|March 25, 2022
Summary
Reticular epithelial corneal edema (RECE) is an adverse effect of Rho-kinase inhibitors (ROCK-I) like netarsudil and ripasudil. Corneal edema and endothelial decompensation are risk factors, requiring cautious use of these drugs.
Area of Science:
- Ophthalmology
- Pharmacology
- Corneal Diseases
Background:
- Novel Rho-kinase inhibitors (ROCK-I), including netarsudil and ripasudil, are used for ophthalmic conditions.
- Reticular epithelial corneal edema (RECE) has been observed as an adverse effect of these drugs.
Purpose of the Study:
- To describe the clinical course, characteristics, and outcomes of RECE associated with topical netarsudil and ripasudil use.
- To identify potential risk factors and clinical stages of ROCK-I-induced RECE.
Main Methods:
- Retrospective observational study of 12 eyes from 11 patients who developed RECE after initiating topical ROCK-I.
- Detailed ophthalmic examinations were performed on all affected patients.
Main Results:
- RECE occurred in eyes treated with both netarsudil (average 25 days) and ripasudil (average 82 days).
- Preexisting corneal edema or ocular comorbidities were noted in seven patients.
- Symptoms and bullae resolved upon discontinuation of ROCK-I, with resolution times varying between drugs.
Conclusions:
- RECE is a potential adverse effect of both netarsudil and ripasudil.
- Patients with prior corneal edema or endothelial decompensation may be at higher risk.
- ROCK-I should be used cautiously in susceptible patients, and further large-scale studies are needed.
