2020–2021 BCSC Basic and Clinical Science Course™
Chapter 12: Medical Management of Glaucoma and Ocular Hypertension
Rho Kinase Inhibitors
The most common adverse event associated with the use of Rho kinase inhibitors is conjunctival hyperemia, which occurs in more than 50%–60% of patients and is thought to be a result of conjunctival vascular smooth muscle cell relaxation. With netarsudil, subconjunctival hemorrhages occur in approximately 15%–20% of patients; eye pruritis, punctate keratitis, increased lacrimation, blepharitis, and decreased visual acuity were each reported in about 5%–10% of patients. Cornea verticillata was observed in approximately 15%–25% of patients after 1 year of use; it is similar in appearance to that observed after long-term use of amiodarone (Fig 4-12). Cornea verticillata does not seem to adversely affect visual function and resolves after a mean of about 1 year after discontinuation of the drug. It is thought to occur as a result of lysosomal accumulation of phospholipids within corneal epithelial cells.
Figure 12-4 Cornea verticillata after use of netarsudil for 3 months.
(Courtesy of Angelo P. Tanna, MD.)
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.