Abstract
To evaluate the efficacy and safety of ripasudil for treatment of secondary glaucoma, a historical cohort study was conducted at 18 centres in Japan. Adults (age ≥20 years) who needed additional IOP reduction and received topical 0.4% ripasudil between 2014 and 2018 due to three secondary glaucoma subtypes, including uveitic glaucoma (UG), exfoliation glaucoma (EG) or steroid-induced glaucoma (SG) were assessed for mean IOP change from baseline prior to additional treatment with ripasudil. We further evaluated the IOP change in each glaucoma subtype, baseline characteristics of each cohort, course of uveitis-induced inflammation in UG eyes, and proportion of patients in each cohort with adverse events. In 332 eyes from 332 patients eligible for this study, the mean overall IOP reductions from baseline at 1, 3, and 6 months were −5.86 ± 9.04 mmHg (−19.4 ± 25.1%), −6.18 ± 9.03 mmHg (−20.0 ± 27.1%), and −7.00 ± 8.60 mmHg (−23.4 ± 25.6%), respectively. These changes were all statistically significant. Of 332 eyes, 109 eyes had UG, 181 had EG, and 42 eyes had SG. The IOP-lowering effects of ripasudil in UG and SG were significantly greater than those of EG at every time point. This finding could have been related to higher baseline IOP levels in UG and SG. UG patients exhibited significant decreases in mean cell score of the anterior segment after ripasudil treatment. No severe adverse events were reported. These findings suggest that treatment with ripasudil is a safe and effective therapeutic modality for IOP reduction in secondary glaucoma.
Highlights
Background factorAgeBaseline intraocular pressure (IOP) prior to ripasudil treatmentLens status between IOP change at 1 month after ripasudil treatment and background factors determined by multiple regression analysis in all patients, uveitic glaucoma (UG) patients, exfoliation glaucoma (EG) patients, and steroid-induced glaucoma (SG) patients are shown in Supplementary Tables 2–5.Course of uveitis activity
A total of 361 patients with glaucoma secondary to uveitis, exfoliation, or steroid use were registered in this retrospective study
Twenty-nine patients were determined ineligible for this study primarily due to lack of sufficient IOP data, and 332 secondary glaucoma patients were eventually enrolled in the study (ROCK-S study: Ripasudil Observational study to Confirm the efficacy and safety of Rho Kinase inhibitor in Japanese patients with Secondary glaucoma)
Summary
Background factorAge (years)Baseline IOP prior to ripasudil treatment (mmHg)Lens status (phakia or not) between IOP change at 1 month after ripasudil treatment and background factors determined by multiple regression analysis in all patients, UG patients, EG patients, and SG patients are shown in Supplementary Tables 2–5.Course of uveitis activity. Baseline IOP prior to ripasudil treatment (mmHg). Lens status (phakia or not) between IOP change at 1 month after ripasudil treatment and background factors determined by multiple regression analysis in all patients, UG patients, EG patients, and SG patients are shown in Supplementary Tables 2–5. Uveitis characteristics (granulomatous or not) PAS index (%). Age (years) Baseline IOP prior to ripasudil treatment (mmHg) Lens status (phakia or not) Topical administration of steroids Cell Scores. Mean Changes in cell score from the baseline −0.16 ± 0.51 −0.19 ± 0.44 −0.18 ± 0.55 Flare Scores.
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