Boston University School of Medicine/Boston Medical Center, Boston, MA.
J Glaucoma. 2022 Nov 1;31(11):920-925. doi: 10.1097/IJG.0000000000002124. Epub 2022 Sep 6.
To describe patients who developed partial or complete punctal closure after the use of topical netarsudil in the treatment of glaucoma, with documented reversal of symptoms on drug cessation.
This is a retrospective, single-center case series including patients treated with topical netarsudil who were documented to have developed punctal disease ipsilateral to the eye(s) being treated. A literature review was also performed to identify other similar reports.
A total of 10 patients were included in the study. Six patients developed partial punctal stenosis and 4 patients developed complete closure of the puncta in 1 or both eye(s) ipsilateral to the use of the topical medication. None of the patients developed punctal disease on the non-netarsudil side. The time from initiation of netarsudil to the documentation of punctal disease ranged from 5-32.2 months (18.41±9.94). In the patients with complete punctal closure, discontinuation of the topical medication led to clinical reappearance of the punctal opening, ranging from 31-83 days after drug cessation (45.75±21.57). In 8 cases, discontinuation of netarsudil resulted in improved epiphora and degree of punctal stenosis on clinical examination.
The use of topical netarsudil for glaucoma may lead to punctal stenosis and complete punctal closure. These side effects of netarsudil are relevant to therapeutic considerations for glaucoma patients.
描述在使用局部曲伏前列素治疗青光眼后出现部分或完全泪点闭锁的患者，这些患者在停止用药后症状有记录证实得到了逆转。
这是一项回顾性、单中心病例系列研究，包括接受局部曲伏前列素治疗且有记录显示同侧（多为单侧）治疗眼出现泪点疾病的患者。还进行了文献复习，以确定其他类似的报告。
共有 10 名患者纳入研究。6 名患者出现部分泪点狭窄，4 名患者出现同侧（单侧）使用局部药物治疗的 1 或 2 只眼的泪点完全闭锁。在非曲伏前列素治疗侧，没有患者发生泪点疾病。从开始使用曲伏前列素到记录到泪点疾病的时间范围为 5-32.2 个月（18.41±9.94）。在完全泪点闭锁的患者中，停止局部用药后泪点开口的临床再现，停药后 31-83 天不等（45.75±21.57）。在 8 例中，停止使用曲伏前列素后，溢泪和泪点狭窄程度在临床检查中得到改善。
局部使用曲伏前列素治疗青光眼可能导致泪点狭窄和完全泪点闭锁。这些曲伏前列素的副作用与青光眼患者的治疗考虑有关。
