Xu H, Lee D, Cho J, Voss J, McDaniel L, An JA. Netarsudil as a Predictor of Response for MicroPulse Transscleral Laser Therapy: A Pilot Study.
Ophthalmol Glaucoma 2022;
5:658-662. [PMID:
35714908 DOI:
10.1016/j.ogla.2022.06.005]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/05/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE
To investigate the role of netarsudil as an outcome predictor of MicroPulse transscleral laser therapy (MPTLT).
DESIGN
Retrospective comparative study.
SUBJECTS
Forty-seven eyes in 33 adult patients with glaucoma with a minimum of 1 month of follow-up after netarsudil treatment and 3 months of follow-up after MPTLT were included. Eyes receiving intraocular pressure (IOP)-lowering procedures in the interim were excluded.
INTERVENTION
Ophthalmic eyedrops of netarsudil at 0.02%, followed by MPTLT treatment.
MAIN OUTCOME MEASURES
Correlation of success between netarsudil and MPTLT. Netarsudil success was defined as an IOP reduction ≥ 20% from baseline, whereas MPTLT success was defined as an IOP reduction ≥ 20% without additional IOP-lowering medications. Secondary outcomes included success rates, mean IOP reduction, adverse effects after each treatment, and netarsudil discontinuation rate.
RESULTS
We found a positive correlation between the netarsudil response and the subsequent MPTLT response (odds ratio, 3.73; 95% confidence interval, 1.05-13.24; P = 0.041). Among netarsudil responders, 73.7% (14/19) of eyes subsequently responded to MPTLT, whereas among netarsudil nonresponders, 42.8% (12/28) of eyes subsequently responded to MPTLT (P = 0.037). From netarsudil, 44.4% of eyes were successful; from MPTLT, 55.3% of eyes were successful. The mean IOP reductions were 2.83 ± 5.74 mmHg from netarsudil and 3.15 ± 6.43 mmHg from MPTLT. Overall, the rate of netarsudil discontinuation was 55.3%. The most common reasons for netarsudil discontinuation were adverse effects (48.9%), followed by high cost (19.1%). The most common adverse effects to netarsudil were conjunctival hyperemia (48.9%) and blurred vision (8.5%). There were no adverse events reported after MPTLT. After MPTLT, 29.8% of eyes required additional IOP-lowering procedures.
CONCLUSIONS
The netarsudil response may serve as a predictive marker of the MPTLT response, with over 70% of netarsudil responders subsequently responding favorably to MPTLT in this study.
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