Abstract
Purpose :
To evaluate the efficacy and safety profile of netarsudil 0.02% ophthalmic solution in a tertiary glaucoma referral center.
Methods :
This retrospective chart review was conducted on glaucoma patients seen at Wills Eye Hospital Glaucoma Service who received netarsudil 0.02% between March and September of 2018. Intraocular pressure (IOP) and best corrected visual acuity (BCVA) comparisons between baseline and months 1 and 3 follow-ups were performed using Student’s t-tests.
Results :
One hundred seventy-two eyes of 108 patients were included. Changes in IOP and BCVA after netarsudil treatment are shown in Table 1. Compared to baseline, a mean (±standard deviation) decrease in IOP of 3.67±4.91 and 3.91±4.83 mmHg was noted at months 1 and 3 follow-up visits, respectively (p<0.001, for both). No statistically significant difference in IOP changes between patients on 3 or more and less than 3 glaucoma medications at month 1 was observed (p=0.667). There was no change in BCVA at either follow-ups compared to baseline. Adverse effects of netarsudil are shown in Table 2. Conjunctival hyperemia was the most common side effect at months 1 and 3 (15.7 and 23.0% of patients, respectively). Blurred vision was reported at months 1 and 3 follow-ups (5.8 and 8.0% of patients, respectively), but no statistically significant difference in BCVA was observed in those patients (p= 0.723 and 0.611, respectively). The rate of drug withdrawal due to side effects or insufficient IOP lowering effect was 7.0% (12 of 172 eyes) at month 1 with a mean of 18.4 days and 17.2% (15 of 87 eyes) between months 1 and 3, with a mean of 60.2 days.
Conclusions :
Netarsudil yielded a significant IOP reduction in glaucoma patients. Of note, significant IOP reductions were observed in patients on three or more medications. Conjunctival hyperemia frequency at month 3 was lower than the previously reported rates. This disparity is likely due to the sub-clinical hyperemia reported in a stringent prospective study which may not be noted by either the patient or physician in the clinical setting. Also, it is possible that not all side effects are captured by chart review, as clinicians may not record all patient complaints or their own observations as carefully as in clinical trials.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.