Reticular Bullous Epithelial Corneal Edema after Netarsudil Use for Elevated Intraocular Pressure with Concurrent Fuchs Endothelial Corneal Dystrophy: A Case Report

• Published in: Case reports in ophthalmology Vol. 15; no. 1; pp. 369 - 373
• Main Authors: Park, Kathryn S., Lieu, Alexander C., Ang, Michael J., Afshari, Natalie A.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2024; Karger Publishers
• Subjects: Case Report; Case reports; Clinical trials; corneal edema; Corneal transplantation; Edema; Editing; Eye surgery; FDA approval; Financial disclosure; fuchs dystrophy; Glaucoma; Hypertension; Kinases; netarsudil; Patients; Pharmacists; Pilot projects; Visual acuity; Writing; United States > US; Corneal edema; Fuchs dystrophy; Netarsudil
• ISSN: 1663-2699; 1663-2699
• DOI: 10.1159/000538119

Abstract Introduction: We describe a case of reticular bullous corneal epithelial edema associated with the use of netarsudil ophthalmic solution (0.02%) for elevated intraocular pressure. Case Presentation: A 74-year-old man with a complex ocular medical history, including Fuchs dystrophy and primary open-angle glaucoma, developed progressively worsening loss of vision 3 weeks following the initiation of topical netarsudil for increased intraocular pressure. Visual acuity in the left eye was counting fingers at 3 feet and intraocular pressure in the left eye was 7 mm Hg. A characteristic “honeycomb” pattern epitheliopathy was seen on ocular examination. Conclusion: Reticular bullous epithelial corneal edema is an uncommon finding associated with netarsudil use, which can be overlooked in favor of corneal edema associated with Fuchs dystrophy. This is especially relevant given Fuchs dystrophy itself is a predisposing risk factor for netarsudil-induced reticular bullous corneal epithelial edema. Improvement of both the corneal edema and visual acuity should be expected after discontinuing netarsudil and undergoing superficial keratectomy.