Effect of 0.002% Omidenepag Isopropyl Eye Drops on the IOP and Cornea of Patients With Normal-Tension Glaucoma
abstract
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Access this abstract nowPRÉCIS
Although Omidenepag isopropyl drops elicited stable intraocular pressure reductions in NTG patients, transient changes in refraction and corneal endothelial cells, significant increase of central corneal thickness, and corneal erosion should be considered.
PURPOSE
To analyze the efficacy and safety of 0.002% omidenepag Isopropyl (OMDI) eye drops in patients with normal tension glaucoma (NTG).
METHODS
Medical records for 62 eyes treated with OMDI for ≥6 months were analyzed. Intraocular pressure (IOP), refraction, keratometry, central corneal thickness (CCT), endothelial cell count, coefficient of variation of endothelial cell area (CV), corneal erosion, and central retinal thickness were compared at baseline and 1, 3, and 6 months.
RESULTS
IOP significantly decreased from 13.4±3.8 to 11.9±3.0, 11.7±2.9, and 12.2±3.3 mm Hg at each follow-up ( P <0.001). Endothelial cell count did not change, but CV transiently increased from 12.6 to 17.0 at 1 month, CCT increased from 531.5 to 538.4 μm, myopia changed from -1.5 to -1.9 D, and keratometry changed from 44.5 to 44.7 D. CV, myopia, and keratometry recovered to baseline at 6 months; however, CCT remained high. Significant corneal erosion was observed at 6 months. Central retinal thickness changes were not observed. There were improvements in prostaglandin-associated skin pigmentation (86.7%), eyelash elongation (40.0%), and deepening of the upper eyelid sulcus and ptosis (~30%) at 3 months after exchange to OMDI. Adverse reactions were corneal erosion (27.4%), corneal thickening (21.0%), conjunctival hyperemia (11.3%), photophobia (5.7%), blurred vision (5.7%), and anterior chamber cells (4.8%).
CONCLUSIONS
OMDI eye drops elicited significant and stable IOP reductions after 6 months in NTG patients with low IOP. However, transient myopic and corneal endothelial cell changes, development of corneal thickening, and corneal erosion should be considered when using OMDI.
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Additional Info
Disclosure statements are available on the authors' profiles:
Influence of 0.002% Omidenepag Isopropyl on Intraocular Pressure and the Cornea in Normal Tension Glaucoma
J. Glaucoma 2023 Apr 01;32(4)245-251, SH Lee, WJ Lee, KW Kim, JH Jeong, IK Park, YS ChunFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Given the transient changes in refraction and corneal endothelial cells, a significant increase in central corneal thickness, and corneal erosion resulting from the use of omidenepag isopropyl (OMDI) eye drops (a selective prostaglandin E2 receptor 2 agonist), the authors of this retrospective study sought to determine the efficacy and safety of 0.002% OMDI eye drops in patients with normal-tension glaucoma. They found that these eye drops, used once daily at night, could "elicit significant intraocular pressure reduction after 1 month of once-daily administration to Asian patients with normal-tension glaucoma [by increasing the rate of aqueous humor drainage through the trabecular and uveoscleral outflow pathways], and its effect lasted for at least 6 months." Notably, the "concomitant use of OMDI with timolol-containing fixed combination drugs showed additive intraocular pressure reductions." Although prostaglandin-associated periorbitopathy and most drug-related adverse effects were mild and infrequent, transient myopic and corneal endothelial cell changes, the development of corneal thickening, and corneal erosion should be considered and discussed with patients when using this eye drop medication. Additionally, some of these issues were related to the study's limitations. To validate these findings in other ethnicities, more studies must be conducted.