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Review

ROCK Inhibitors in Corneal Diseases and Glaucoma—A Comprehensive Review of These Emerging Drugs

by
Luca Pagano
1,
Jason William Lee
2,
Matteo Posarelli
3,4,
Giuseppe Giannaccare
5,*,
Stephen Kaye
3 and
Alfredo Borgia
3,6
1
Department of Biomedical Sciences, Humanitas University, 20072 Milano, Italy
2
Clinical Eye Research Centre, St Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8YE, UK
3
Department of Corneal Diseases, St. Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8YE, UK
4
Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
5
Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
6
Eye Unit, Humanitas-Gradenigo Hospital, 10122 Turin, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2023, 12(21), 6736; https://doi.org/10.3390/jcm12216736
Submission received: 19 September 2023 / Revised: 17 October 2023 / Accepted: 23 October 2023 / Published: 25 October 2023
(This article belongs to the Special Issue New Advances in Optic Nerve Diseases)
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Abstract

Rho kinase (ROCK) inhibitors have gained significant attention as emerging novel treatment options in the field of ophthalmology in recent years. The evidence supporting their efficacy in glaucoma and corneal pathology includes both in vitro and clinical studies. Among the available options, ripasudil and netarsudil have emerged as the leading ROCK inhibitors, and some countries have approved these therapeutic options as treatments for glaucoma. Various dosing regimens have been studied, including monotherapy and combination therapy, especially for patients with secondary glaucoma who are already on multiple medications. Another rising application of ROCK inhibitors includes their use as an adjunct in surgical procedures such as Descemetorhexis Without Endothelial Keratoplasty (DWEK), Descemet Stripping Only (DSO) to accelerate visual recovery, glaucoma surgeries to reduce scarring process and allow better intraocular pressure (IOP) control, or after complicated anterior segment surgery to treat corneal oedema. This article provides a comprehensive overview of the existing literature in the field, offering recommendations for prescribing ROCK inhibitors and also discussing patient selection, drug efficacy, and possible adverse effects.
Keywords: rho kinase; cornea guttata; Descemet membrane; glaucoma; ripasudil; netarsudil rho kinase; cornea guttata; Descemet membrane; glaucoma; ripasudil; netarsudil

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MDPI and ACS Style

Pagano, L.; Lee, J.W.; Posarelli, M.; Giannaccare, G.; Kaye, S.; Borgia, A. ROCK Inhibitors in Corneal Diseases and Glaucoma—A Comprehensive Review of These Emerging Drugs. J. Clin. Med. 2023, 12, 6736. https://doi.org/10.3390/jcm12216736

AMA Style

Pagano L, Lee JW, Posarelli M, Giannaccare G, Kaye S, Borgia A. ROCK Inhibitors in Corneal Diseases and Glaucoma—A Comprehensive Review of These Emerging Drugs. Journal of Clinical Medicine. 2023; 12(21):6736. https://doi.org/10.3390/jcm12216736

Chicago/Turabian Style

Pagano, Luca, Jason William Lee, Matteo Posarelli, Giuseppe Giannaccare, Stephen Kaye, and Alfredo Borgia. 2023. "ROCK Inhibitors in Corneal Diseases and Glaucoma—A Comprehensive Review of These Emerging Drugs" Journal of Clinical Medicine 12, no. 21: 6736. https://doi.org/10.3390/jcm12216736

APA Style

Pagano, L., Lee, J. W., Posarelli, M., Giannaccare, G., Kaye, S., & Borgia, A. (2023). ROCK Inhibitors in Corneal Diseases and Glaucoma—A Comprehensive Review of These Emerging Drugs. Journal of Clinical Medicine, 12(21), 6736. https://doi.org/10.3390/jcm12216736

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