Netarsudil as an Add-On Therapy for Glaucoma Patients Who Are Already on Maximally Tolerated Topical Medical Therapy (Code-T0333)

Introduction: Glaucoma is a progressive optic neuropathy characterized by increased intraocular 
pressure (IOP), leading to irreversible vision loss. Despite the availability of multiple anti
glaucoma medications, many patients fail to achieve target IOP, necessitating additional 
therapeutic options. Netarsudil, a Rho kinase inhibitor, is a novel agent that enhances aqueous 
outflow and reduces IOP. This study evaluates the IOP-lowering efficacy and safety of 
Netarsudil as an adjunct therapy in glaucoma patients already on maximally tolerated topical 
medical treatment. 
Aims and Objectives 
Aim: To study the intraocular pressure (IOP) lowering effect of Netarsudil 0.02% eye drops after 
a period of 3 months in Glaucoma patients who are already on maximum tolerated topical 
medical therapy for at least past 1 month. 
Objective: To study the add on IOP lowering effect of Netarsudil 0.02% eye drops after a period 
of 3 months. 
Methods: A prospective, hospital-based, single-arm study was conducted at Lady Hardinge 
Medical College, New Delhi, from November 2022 to February 2024. Thirty eyes of 17 patients 
with uncontrolled IOP despite maximal medical therapy were included. Netarsudil 0.02% was 
administered once daily, and IOP was measured at baseline, 1 week, 1 month, and 3 months 
using Goldmann Applanation Tonometry. Adverse effects and target IOP achievement were also 
assessed. 
Results: At 3 months, Netarsudil significantly reduced IOP by 3.64 mmHg (19.64%, p<0.0001). 
Target IOP was achieved in 55.17% of eyes. The most common side effect was conjunctival 
hyperemia (10.34%), with no serious adverse events. 
Conclusion: Netarsudil 0.02% is an effective and safe adjunct therapy for glaucoma patients 
with uncontrolled IOP on maximal medical therapy. Its IOP-lowering effect and tolerability 
make it a promising addition to glaucoma management. 
Keywords: Glaucoma, Netarsudil, Intraocular Pressure, Rho Kinase Inhibitor, Ocular 
Hypertension, IOP Reduction.