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与奈他地尔/拉坦前列素相关的角膜形态和屈光度的快速可逆改变

"Rapid and reversible alteration in corneal contour and power associated with Netarsudil/Latanoprost".

作者信息

Chung David, Meier Edward J

机构信息

University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA.

Cincinnati Eye Institute, 6150 Radio Way, Mason, OH, 45040, USA.

出版信息

Am J Ophthalmol Case Rep. 2022 Mar 25;26:101501. doi: 10.1016/j.ajoc.2022.101501. eCollection 2022 Jun.

Abstract

PURPOSE

To describe a previously unreported case of reversible myopic shift with corresponding changes in corneal contour in a patient treated with netarsudil/latanoprost.

OBSERVATIONS

A 72-year-old male with history of primary open angle glaucoma, prior cataract surgery, and remote radial keratotomy surgery was treated with fixed-dose combination of netarsudil/latanoprost. Despite no prior history of refractive shift in the twenty years since radial keratotomy surgery, on one month follow-up, he reported reduced visual acuity and presented with approximately 1.50 D shift in both eyes. There were associated corneal contour changes. No corneal epithelial bullae or edema were appreciated. Netarsudil/latanoprost was discontinued and timolol was initiated. One month later, both refractive error and corneal contour returned to prior levels.

CONCLUSIONS

Netarsudil is a rho-kinase and norepinephrine transporter inhibitor that may be effective in the treatment of primary open angle glaucoma resistant to other topical treatments. In addition to corneal epithelial bullous edema previously reported, this drug may induce reversible changes in corneal contour in patients with prior corneal or refractive surgery.

摘要

目的

描述一例在用奈他地尔/拉坦前列素治疗的患者中出现的先前未报道的可逆性近视性移位及相应角膜形态改变的病例。

观察结果

一名72岁男性,有原发性开角型青光眼病史、既往白内障手术史及既往放射状角膜切开手术史,接受了固定剂量的奈他地尔/拉坦前列素联合治疗。尽管自放射状角膜切开手术以来的20年里没有屈光移位的既往史,但在1个月的随访中,他报告视力下降,双眼出现约1.50 D的移位。伴有角膜形态改变。未发现角膜上皮大疱或水肿。停用奈他地尔/拉坦前列素并开始使用噻吗洛尔。1个月后,屈光不正和角膜形态均恢复到先前水平。

结论

奈他地尔是一种Rho激酶和去甲肾上腺素转运体抑制剂,可能对其他局部治疗无效的原发性开角型青光眼有效。除了先前报道的角膜上皮大疱性水肿外,这种药物可能会在有既往角膜或屈光手术史的患者中引起角膜形态的可逆性改变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f85a/8978266/434e913e39f4/gr1.jpg

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