Late-Onset Ocular Hypotensive Effect of Ripasudil on Primary Open-Angle Glaucoma

Area of Science:

• Ophthalmology
• Pharmacology

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Effective long-term management of POAG is crucial for preserving vision.
• Ripasudil is a Rho-kinase inhibitor used for glaucoma treatment.

Purpose of the Study:

• To evaluate the late-onset ocular hypotensive effect of ripasudil in patients with POAG using real-world clinical data.
• To identify factors associated with this late-onset effect.

Main Methods:

• A retrospective review of POAG patients newly treated with ripasudil was conducted.
• Patients were categorized into 'positive' (late-onset effect) and 'negative' groups based on intraocular pressure reduction at 6 months.
• Logistic regression analysis was used to determine factors associated with the late-onset effect.

Main Results:

• 16.2% of 74 POAG eyes exhibited a late-onset hypotensive effect from ripasudil.
• The positive group had significantly higher baseline intraocular pressure (IOP) and thicker retinal nerve fiber layer (RNFL) thickness compared to the negative group.
• Higher baseline IOP (OR, 1.22) and thicker RNFL (OR, 2.76) were significantly associated with the late-onset effect.

Conclusions:

• Ripasudil can induce a late-onset IOP-lowering effect in a subset of POAG patients.
• This effect is associated with higher baseline IOP and thicker RNFL.
• Ripasudil may be particularly beneficial for early-stage glaucoma patients with thicker RNFL.