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Reticular epithelial corneal edema as a novel side-effect of Rho Kinase Inhibitors: An Indian scenario

Indian journal of ophthalmology, 2022-04, Vol.70 (4), p.1163-1170 [Peer Reviewed Journal]

COPYRIGHT 2022 Medknow Publications and Media Pvt. Ltd. ;2022. This article is published under (http://creativecommons.org/licenses/by-nc-sa/3.0/) (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Copyright: © 2022 Indian Journal of Ophthalmology 2022 ;ISSN: 0301-4738 ;EISSN: 1998-3689 ;DOI: 10.4103/ijo.IJO_2865_21 ;PMID: 35326007

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  • Title:
    Reticular epithelial corneal edema as a novel side-effect of Rho Kinase Inhibitors: An Indian scenario
  • Author: Bhargava, Mona ; Sen, Surajit ; Bhambhani, Varsha ; Paul, Raj ; Dutta, Chandana
  • Subjects: Acuity ; anterior segment optical coherence tomography ; Blister - complications ; Cornea ; Corneal diseases ; Corneal Edema - chemically induced ; Corneal Edema - diagnosis ; Dropsy ; Edema ; Eye ; honeycomb edema ; Humans ; Original ; Patients ; reticular epithelial corneal edema ; Rho-associated kinase ; rho-Associated Kinases ; rho-kinase inhibitors ; Risk factors ; Side effects ; Statistics ; Visual Acuity
  • Is Part Of: Indian journal of ophthalmology, 2022-04, Vol.70 (4), p.1163-1170
  • Description: Purpose: To describe clinical course, characteristics, and outcome of reticular epithelial corneal edema (RECE) occurring as a not-so-infrequent adverse effect of a novel drug, Rho-kinase inhibitors (ROCK-I)- netarsudil (0.02%) and ripasudil (0.4%). Methods: This was a retrospective observational non-randomized study. In this study, 12 eyes of 11 patients presenting at a tertiary eye care center between April 2021 and September 2021 were included. All 12 eyes developed a distinctive honeycomb pattern of RECE after starting topical ROCK-I. All patients were subjected to detailed ophthalmic examinations. Results: Eight patients were started on netarsudil (0.02%) and three on ripasudil (0.4%). Five eyes had a prior history of corneal edema. The remaining seven had the presence of ocular comorbidities predisposing to corneal edema. The average time for RECE occurrence was 25 days for netarsudil and 82 days for ripasudil. Visual acuity decreased in two eyes, remained unaffected in four eyes, and could not be quantified in four eyes due to preexisting profound visual impairment. Five eyes had symptoms of ocular surface discomfort associated with bullae. Symptoms and bullae resolved in all eyes in whom ROCK-I was stopped. The average time to resolution of RECE was 10 days for netarsudil and 25 days for ripasudil. Conclusion: RECE after ROCK-I occurs with the use of both netarsudil and ripasudil, although the characteristics differ. The presence of corneal edema and endothelial decompensation seem to be a risk factor, and cautious use is warranted in these patients. Four clinical stages of RECE are described. ROCK-I act as a double-edged sword in patients with endothelial decompensation. Large-scale studies are required to know the exact incidence, pathophysiology, and long-term consequences of the aforementioned side-effect.
  • Publisher: India: Wolters Kluwer India Pvt. Ltd
  • Language: English
  • Identifier: ISSN: 0301-4738
    EISSN: 1998-3689
    DOI: 10.4103/ijo.IJO_2865_21
    PMID: 35326007
  • Source: Open Access: PubMed Central
    Geneva Foundation Free Medical Journals at publisher websites
    AUTh Library subscriptions: ProQuest Central
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