Topical Fasudil in Type 2 Retinopathy of Prematurity: A Pilot Study

To evaluate the safety and effectiveness of topical fasudil drop, as a Rho kinase (ROCK) inhibitor agent, on type 2 retinopathy of prematurity (ROP).

This comparative case series included 42 eyes of 21 premature infants with type 2 ROP. One eye of each patient was randomly assigned to receive a fasudil eye drop of 0.5% twice a day. The other eye received artificial tear drops twice a day as a control. The administration began at the time of prethreshold ROP diagnosis until 45 weeks of postmenstrual age. Funduscopic examination was performed weekly until complete retinal vascularization or progression into type 1 ROP. The extent of the retinal avascular area or progression into type 1 prethreshold ROP was compared between the two eyes of each infant. The influence of associated systemic conditions on the process of angiogenesis was also evaluated.

In 5 (23.8%) premature infants, reduction of the avascular zone area was observed in eyes treated with fasudil drop compared to the other eye (P = 0.808). In 16 (76.2%) premature infants, no difference in the size of the avascular area was observed between the two eyes. None of the studied systemic factors influenced the reduction in the size of the avascular area, except for weight gain. However, the correlation between weight gain and reduction in avascular area size was only marginally significant (P = 0.052).

Topical 0.5% fasudil was safe, but showed no statistically significant benefit in reducing the avascular zone or preventing progression to type 1 ROP in this pilot study.