Early intraocular pressure‑lowering effects of the Rho kinase inhibitor ripasudil in patients with uveitic glaucoma
Ryoji Yanai, MD, PhD
Sho-Hei Uci, Tadahiko Ogata, Makoto Hatano, Masaaki Kobayashi, Tomohiko Nagai, Shin-ichiro Teranishi, Kazuhiro Kimura
Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Japan
Purpose A Rho kinase (ROCK) inhibitor, ripasudil, is a topical agent for intraocular pressure (IOP) reduction and a potent anti-inflammatory agent against ocular inflammatory diseases, including acute uveitis, and possibly uveitic glaucoma. The present study aimed to investigate the effectiveness of ripasudil in IOP reduction in patients with uveitic glaucoma.
Methods In total, fifty four (54) patients who underwent adjunctive therapy with ripasudil at a single institution were included. They were classified into the uveitic glaucoma group (secondary) and the non-uveitic glaucoma group. In both the groups, the average IOPs were compared at zero (baseline), then 1, 3, and finally, 6 months after the addition of ripasudil.
Results The percentage break down of uveitic glaucoma was as follows: sarcoidosis (26%), herpetic iridocyclitis (15%), cytomegalovirus iridocyclitis (7%), others (26%), and unclassified (26%). Similarly, the percentage distribution of non-uveitic glaucoma was as follows: primary open-angle glaucoma (39%), secondary glaucoma associated without uveitis (23%), steroid glaucoma (19%), exfoliation glaucoma (15%), and ocular hypertension (4%). The median IOPs (mmHg) for both the uveitis group and the non-uveitis group at zero, 1, 3, and 6 months after the ripasudil therapy were 22, 19, 14, and 14, and 20, 19, 18, and 15, respectively. Significant IOP reduction was observed earlier in the uveitic glaucoma group, which was 3 months after the start of ripasudil therapy, compared with that in the non-uveitic glaucoma group, which was 6 months after the start of the ripasudil therapy.
Conclusions Ripasudil is useful for lowering IOP in glaucoma patients with uveitis; moreover, these reductions occur comparatively earlier than those in glaucoma patients without uveitis.