Question

Role of Rho kinase inhibitors in Ophthalmology.

Hint:

Rho kinase inhibitors offer an alternative mechanism for lowering IOP and improving retinal health, especially in glaucoma and retinal vascular diseases.

Answer 1

Rho kinase inhibitors are a class of drugs that target the Rho kinase pathway, a key regulator of cellular contraction, actin cytoskeleton dynamics, and endothelial permeability. In ophthalmology, Rho kinase inhibitors have emerged as a promising treatment for various ocular conditions.
Role of Rho Kinase Inhibitors in Ophthalmology:
1. Glaucoma Management:
- Rho kinase inhibitors (such as Netarsudil) work by reducing intraocular pressure (IOP) through two mechanisms:
- Increasing aqueous humor outflow by relaxing the trabecular meshwork.
- Enhancing uveoscleral outflow, another drainage pathway for aqueous humor.
- Netarsudil (Rhopress is the first FDA-approved Rho kinase inhibitor for open-angle glaucoma. It works as both a pressure-lowering agent and a vasodilator, improving blood flow to the optic nerve.
2. Retinal Diseases:
- Rho kinase inhibitors can improve retinal blood flow and reduce vascular leakage, which is important in conditions like diabetic retinopathy, age-related macular degeneration (AM, and retinal vein occlusion (RVO).
- Their role in modulating inflammation and vascular permeability is still under investigation but shows promise in improving retinal function and reducing edema.
3. Post-surgical Healing:
- Rho kinase inhibitors have also been explored to enhance wound healing in the eye following procedures such as trabeculectomy and cataract surgery by promoting cell migration and tissue repair.