Reticular Bullous Epithelial Corneal Edema after Netarsudil Use for Elevated Intraocular Pressure with Concurrent
Kathryn S Park1, Alexander C Lieu1, Michael J Ang1
1Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, San Diego, CA, USA.
Case Reports in Ophthalmology
|April 18, 2024
Summary
Netarsudil eye drops can cause reticular bullous corneal epithelial edema, a rare side effect. This condition, especially in patients with Fuchs dystrophy, may improve after discontinuing netarsudil.
Area of Science:
- Ophthalmology
- Corneal Diseases
- Pharmacology
Background:
- Elevated intraocular pressure (IOP) requires management.
- Netarsudil ophthalmic solution is used to lower IOP.
- Fuchs dystrophy is a common corneal condition.
Observation:
- A 74-year-old male with Fuchs dystrophy and glaucoma developed vision loss after starting netarsudil.
- Ocular examination revealed a "honeycomb" pattern epitheliopathy.
- Visual acuity decreased significantly, while IOP was low.
Findings:
- Netarsudil use was associated with reticular bullous corneal epithelial edema.
- Fuchs dystrophy is a risk factor for this specific corneal edema.
- The condition can be mistaken for other forms of corneal edema.
Implications:
- Discontinuation of netarsudil is recommended for managing this side effect.
- Superficial keratectomy may be necessary for severe cases.
- Early recognition is crucial to prevent vision loss and manage IOP effectively.
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