Honeycomb Epithelial Edema Associated With Rho Kinase Inhibition: A Case Series and Review of the Literature

Lyons, Lance J.; Wu, Kristi Y; Baratz, Keith H.; Sit, Arthur J.

doi:10.1097/ico.0000000000002694

Cited by 11 publications

(7 citation statements)

References 16 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 20 ] Previous authors have described preexisting corneal edema as a risk factor for the occurrence of RECE. [ 14 15 16 17 18 ] All but two patients (one by Moumneh et al . [ 14 ] and one by Wisely et al .…”

Section: Discussionmentioning

confidence: 99%

“…The decline in VA was the only significant symptom reported in all previous reports describing RECE. [ 14 15 16 17 18 ] No other symptoms associated with bullae have been reported. In our study, we found additional symptoms of foreign body sensation, eye pain, and ocular surface discomfort attributable to bullae in five eyes.…”

Section: Discussionmentioning

confidence: 99%

“…It has recently been described after netarsudil use only by a few authors. [ 14 15 16 17 18 ] For ripasudil, we could only find a mention of it in an article on Descemet’s stripping without endothelial keratoplasty (DWEK) by Garcerant et al ,[ 19 ] and that too as an additional clinical sign.…”

mentioning

confidence: 99%

See 2 more Smart Citations

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

Bhargava

Sen

Bhambhani

et al. 2022

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Bhargava

Sen

Bhambhani

et al. 2022

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…More reports feature in recent literature on the topical use of netarsudil 0.02% (Rho-Kinase inhibitor and norepinephrine transport inhibitor), causing macrocellular reticular pattern of epithelial edema in eyes with pre-existing stromal edema and raised intraocular pressure. [ 2 3 4 5 6 7 8 ] This unique pattern of edema has been observed in the clinical setting of pre-existing endothelial cell dysfunction when netarsudil is used. Rho-kinase (ROCK) inhibitors regulate and increase the permeability of tight junctions, thereby permitting fluid movement from the corneal stroma to the epithelium.…”

mentioning

confidence: 93%

Letter to Editor on “Nair AV, Rosette D, Rajaraman R. Netarsudil-associated reticular epithelial edema in a corneal ulcer. Indian J Ophthalmol Case Rep 2022; 2:649-51”

Vanathi

Beniwal

2023

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

“…Watering of the eyes, corneal staining, and blurred or reduced vision are other side effects being less observed or reported. [ 2 3 4 5 ]…”

Section: Introductionmentioning

confidence: 99%

Reticular corneal epithelial edema with topical netarsudil

Parmar

Bhole²,

Garde³

2023

Oman J Ophthalmol

View full text Add to dashboard Cite

Rho-associated protein kinase inhibitor (ROCK) therapy for corneal endothelial dysfunction or damage other than glaucoma has been reported with few ocular side effects. We report reticular epithelial edema (REE) with netarsudil (0.02%) therapy in four cases with different clinical scenarios (three cases with corneal transplant and one case postcataract extraction). REE developed in all cases variably and cleared on cessation of netarsudil in three cases. One case was continued on netarsudil due to REE sparing the visual axis with no active ocular complaints. Partial clearance of stromal edema observed in all cases was correlated clinically to visual acuity considering existing comorbidities in an individual case.

show abstract

Honeycomb Epithelial Edema Associated With Rho Kinase Inhibition: A Case Series and Review of the Literature

Cited by 11 publications

References 16 publications

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

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

Letter to Editor on “Nair AV, Rosette D, Rajaraman R. Netarsudil-associated reticular epithelial edema in a corneal ulcer. Indian J Ophthalmol Case Rep 2022; 2:649-51”

Reticular corneal epithelial edema with topical netarsudil

Contact Info

Product

Resources

About