Abstract
Purpose :
Netarsudil is a new class medication targeting rho-kinase inhibition and increasing trabecular meshwork outflow. Published studies have proven its efficacy alone and in combination with latanoprost as primary therapy. This study retrospectively investigated the one year efficacy of adjunctive use of netarsudil in refractory cases of glaucoma at a tertiary care glaucoma clinic. Refractory cases were judged as requiring ≥3 topical medications for intraocular pressure (IOP) control.
Methods :
Retrospective chart review for patients on ≥3 topical medications who received add-on netarsudil was conducted from 01/01/2018 to 08/31/2020. Patients’ baseline characteristics prior to add-on therapy were recorded and included type of glaucoma, prior topical, laser, and surgical treatments. A baseline IOP was calculated by taking the average of the two most recent IOP measurements prior to netarsudil add-on treatment. IOP was measured at 3-, 6-, and 12-month intervals ±4 week windows. A Bonferroni corrected student’s T-test was used to test differences between groups with statistical significance set at p = 0.01
Results :
69 eyes in 47 patients were included in this analysis. Mean age (±SD) was 72.0±12.2. 22 (47%) African American, 15 (32%) patients were Caucasian, and 10 (21%) Hispanic. Glaucoma diagnosis was as follows: 55 (80%) primary open angle, 4 (6%) uveitic, 4(6%) neovascular, 2 (3%) normal tension glaucoma, 2 (3%) exfoliation. Prior surgeries included: 21 (30%) seton, 13 (19%) trabeculoplasty, 4 (6%) trabeculectomy, 4 (6%) iStent, (1%) iridotomy. Mean IOP mmHg (±SD) at baseline was 20.7±5.8. Follow-up mean IOP mmHg (±SD) are as follows: 3-month 17.8±6.7 (p<0.008) in 64 eyes, 6-month 17.8±4.6 (p<0.008) in 56 eyes, 12-month 17.4±6.8 (p<0.008) in 44 eyes.
Conclusions :
Adjunctive use of netarsudil in refractory glaucoma showed clinically and statistically significant IOP reductions. This study suggests that adding netarsudil to eyes with previous medical or surgical treatment can provide longer term IOP reduction. Further analysis is required to fully understand the effect of netarsudil in refractory glaucoma.
This is a 2021 ARVO Annual Meeting abstract.