Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA.
Curr Opin Ophthalmol. 2021 May 1;32(3):268-274. doi: 10.1097/ICU.0000000000000748.
Rho kinase (ROCK) inhibitors are growing increasingly relevant in ophthalmology, and the goal of this review is to summarize their mechanisms of action and potential applications in the subspecialties of glaucoma, retina, and cornea. We will focus specifically on corneal endothelial wound healing, for which ROCK inhibition demonstrates particular promise.
ROCK inhibition has been shown to promote corneal endothelial cell proliferation, increase intercellular adhesion, and suppress apoptosis. Topical ROCK inhibitor treatment has exhibited potential use in Fuchs endothelial dystrophy, corneal edema from acute surgical trauma and other etiologies, and tissue engineering therapy for the endothelial disease. Ripasudil and netarsudil, the two ROCK inhibitors available for ophthalmic use, are generally very well tolerated with mild and transient local side effects.
ROCK inhibitors are revolutionizing the subspecialty of cornea, and further research is needed to compare long-term outcomes of ROCK inhibitor therapy to those of conventional endothelial keratoplasty, including visual acuity and endothelial cell density. Other possible avenues include the use of ROCK inhibitors to prolong corneal graft survival, and early data appears promising.
Rho 激酶（ROCK）抑制剂在眼科学领域的应用日益广泛，本综述旨在总结其作用机制及其在青光眼、视网膜和角膜等亚专科中的潜在应用。我们将特别关注角膜内皮伤口愈合，ROCK 抑制在此方面显示出特殊的应用前景。
ROCK 抑制已被证明可促进角膜内皮细胞增殖、增加细胞间黏附、抑制细胞凋亡。局部 ROCK 抑制剂治疗已显示出在 Fuchs 内皮营养不良、急性手术创伤和其他病因引起的角膜水肿以及内皮疾病的组织工程治疗中的潜在用途。目前有两种用于眼科的 ROCK 抑制剂，即 ripasudil 和 netarsudil，它们通常具有良好的耐受性，仅有轻微和短暂的局部副作用。
ROCK 抑制剂正在彻底改变角膜亚专科领域，需要进一步研究以比较 ROCK 抑制剂治疗与传统内皮角膜移植术的长期效果，包括视力和内皮细胞密度。其他可能的途径包括使用 ROCK 抑制剂延长角膜移植物的存活时间，早期数据显示出良好的前景。
