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Abstract #90532 Published in IGR 21-3
Netarsudil-associated epithelial keratopathy
Ramakrishnan MS; Addis VM; Lehman AY; Sankar PSAmerican journal of ophthalmology case reports 2020; 19: 100800
PURPOSE: To report 2 cases with a novel finding of bullous epithelial keratopathy associated with netarsudil use. OBSERVATIONS: A 72-year-old man with history of primary open angle glaucoma was started on netarsudil daily in both eyes for uncontrolled intraocular pressures despite treatment with latanoprost, brimonidine, and dorzolamide-timolol. One month later he presented with bilateral conjunctival hyperemia, predominantly inferior corneal epithelial bullae, and keratic precipitates without hypopyon. Netarsudil was discontinued, and the patient was started on topical steroids. One week later, the hyperemia and corneal edema had resolved while many small keratic precipitates persisted.A 29-year-old man with history of rubella-associated glaucoma and chronic postoperative inflammation on prednisolone was started on netarsudil in his left eye only for elevated intraocular pressures despite latanoprost, brimonidine, and dorzolamide-timolol. Two months later, he complained of eye pain and decreased vision since starting netarsudil. Examination revealed mild hyperemia and inferior corneal epithelial bullae without keratic precipitates. Netarsudil was discontinued, and two weeks later, conjunctival injection resolved and cornea cleared. CONCLUSIONS AND IMPORTANCE: Netarsudil ophthalmic solution 0.02% (Rhopressa) is a rho-kinase inhibitor recently approved for lowering intraocular pressure in open-angle glaucoma or ocular hypertension. As netarsudil continues to be increasingly used, physicians and patients need to be aware of this new possible adverse effect.
Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, 51 N. 39th Street, Philadelphia, PA, 19104, USA.
Full articleClassification:
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
11.15 Other drugs in relation to glaucoma (Part of: 11 Medical treatment)
