Additive intraocular pressure-lowering effects of the Rho kinase inhibitor ripasudil in Japanese patients with various subtypes of glaucoma.

Purpose: The present study aimed to investigate the effectiveness of adjunctive therapy involving the Rho-associated, coiled-coil-containing protein kinase (ROCK) inhibitor ripasudil in lowering intraocular pressure (IOP) in patients with different subtypes of glaucoma, on the basis of the time of IOP measurement STUDY DESIGN: Retrospective study METHODS: In total, 58 patients who underwent adjunctive therapy with ripasudil at a single institution were included. They were classified into a primary open-angle glaucoma (POAG) group, an exfoliation glaucoma (XFG) group, and a secondary glaucoma associated with uveitis, or steroid glaucoma (SG), group. The average IOPs within 6 months before (pre-IOP) and after (post-IOP) the addition of ripasudil were compared among the 3 groups. The IOP values of the morning-visit and afternoon-visit groups were also compared to reflect the peak effectiveness of ripasudil.

Results: The IOP reductions in the POAG (n = 38), XFG (n = 6), and SG (n = 14) groups were -1.1, +0.5, and +0.5 mmHg, respectively. Significant reductions in IOP were observed in the POAG group (P = .014). The IOP reductions in the POAG morning-visit and afternoon-visit groups were -1.9 and +0.5 mmHg, respectively. IOP was significantly reduced in the morning-visit POAG group after treatment with ripasudil (P = .002). The IOP values measured during morning visits were lower than those measured during afternoon visits (IOP reduction: -1.3 mmHg; P = .011).

Conclusions: The findings of the present study indicate that ripasudil is effective as an adjunctive therapy for lowering IOP in patients with POAG; these reductions are more significant when measured closer to the time of peak effectiveness.