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Related Concept Videos

Open Angle Glaucoma: Treatment01:27

Open Angle Glaucoma: Treatment

In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
Glaucoma: Overview01:25

Glaucoma: Overview

Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...

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Related Experiment Videos

Longitudinal Structural and Functional Trajectories Following Netarsudil Intensification or Surgical Escalation in

Eun Seong Kim1, Sang Wook Jin1

  • 1Department of Ophthalmology, Dong-A University, College of Medicine, Busan, Korea.

Seminars in Ophthalmology
|July 3, 2026
PubMed
Summary

Adjunctive netarsudil intensification and immediate surgical escalation for medically uncontrolled primary open-angle glaucoma (POAG) showed similar short-term structural and functional trajectories over 12 months. Surgery provided greater intraocular pressure reduction, but netarsudil required escalation in 27% of cases.

Keywords:
Longitudinal progressionnetarsudilprimary open-angle glaucomaretinal nerve fiber layervisual field

Related Experiment Videos

Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Medical Interventions

Background:

  • Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
  • Effective management of medically uncontrolled POAG is crucial for preserving vision.
  • Treatment intensification strategies include medical escalation or surgical intervention.

Purpose of the Study:

  • To compare short-term structural and functional progression in POAG patients.
  • To evaluate outcomes of netarsudil intensification versus immediate surgical escalation.
  • To characterize visual field and retinal nerve fiber layer (RNFL) changes.

Main Methods:

  • Retrospective cohort study of 110 eyes with medically uncontrolled POAG.
  • Comparison between netarsudil intensification (37 eyes) and surgical escalation (73 eyes).
  • Analysis of 12-month slopes for mean deviation (MD), RNFL thinning, and intraocular pressure (IOP) reduction using stabilized inverse probability weighting.

Main Results:

  • No significant difference in MD progression rate (-0.61 dB/year vs -0.42 dB/year; p=0.112) or RNFL thinning rate (-1.8 µm/year vs -1.1 µm/year; p=0.138) between groups.
  • Surgical management achieved significantly greater IOP reduction (-12.3 mmHg vs -5.4 mmHg; p<0.001).
  • 27% of eyes in the netarsudil group required subsequent surgery.

Conclusions:

  • Short-term structural and functional trajectories were similar between netarsudil intensification and surgical escalation over 12 months.
  • While surgery yielded superior IOP reduction, functional and structural outcomes did not significantly differ in the short term.
  • Netarsudil intensification may be a viable option, but requires monitoring for potential subsequent surgical escalation.