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Transient Reticular Cystic Corneal Epithelial Edema With Topical Netarsudil: A Case Series and Review
- Source :
- Cornea. 40(8)
- Publication Year :
- 2020
-
Abstract
- Purpose To describe cases in which netarsudil ophthalmic solution 0.02% precipitated reversible, reticular cystic epithelial edema. Methods A retrospective case review at the Brooklyn Veteran's Association Hospital of patients with corneal stromal edema that were treated with netarsudil and subsequently developed cystic epithelial edema. Results Four male patients with a mean age of 72 ± 8.0 years developed a reticular, honeycomb-like pattern of epithelial edema located in the interpalpebral and inferior cornea. In 3 of 4 patients, epithelial edema arose within 1 month compared with 2 months in 1 patient. New epithelial cysts did not correlate with worsening central corneal thickness and best spectacle-corrected visual acuity in every patient, which was likely due to the location of the cysts. Two of 4 patients developed increased central corneal thickness with worsening best spectacle-corrected visual acuity. In comparison, 1 patient had improvement in both parameters, whereas 1 patient had no significant change. In all cases, there was resolution of the epithelial cysts after discontinuation of netarsudil. Conclusions Although rho-kinase inhibitors have been suggested to improve endothelial function, we have documented worsening epithelial cysts in a subset of patients with pre-existing corneal edema. These effects of netarsudil were transient and resolved after discontinuing treatment within 2 weeks in most patients. We hypothesize that the incidence of this adverse finding is more common than previously believed. Nevertheless, large-scale studies are needed to accurately report on the incidence and clinical significance of this novel finding.
- Subjects :
- Male
medicine.medical_specialty
Visual acuity
Visual Acuity
Slit Lamp Microscopy
Benzoates
03 medical and health sciences
0302 clinical medicine
Edema
Ophthalmology
Cornea
medicine
Humans
Clinical significance
Corneal stromal edema
Intraocular Pressure
Aged
Retrospective Studies
Aged, 80 and over
rho-Associated Kinases
business.industry
Incidence (epidemiology)
Corneal Edema
Epithelium, Corneal
Discontinuation
medicine.anatomical_structure
Reticular connective tissue
030221 ophthalmology & optometry
beta-Alanine
medicine.symptom
Ophthalmic Solutions
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15364798
- Volume :
- 40
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Cornea
- Accession number :
- edsair.doi.dedup.....72dd4339a2d32f56dd569ca5650e9df1