Intravitreal Fasudil Monotherapy for Treatment of Refractory Diabetic Macular Edema: a Prospective, Interventional Case-series
Ramin Nourinia1 *, Hamid Ahmadieh1 , Ebrahim Gerami1 , Seyed-Hossein Abtahi1 , Jamil Eslampour1 , Sahba Fekri1
- Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract: Purpose: To evaluate the effect of three monthly intravitreal injections of a Rho-associated protein kinase (ROCK) inhibitor (Fasudil, Asahi Kasei Pharma Corporation, Tokyo, Japan) on refractory diabetic macular edema (DME).
Methods: Methods: This prospective, interventional case series included 10 eyes of 10 patients with DME unresponsive to at least five previous intravitreal bevacizumab (IVB) injections. Eligible eyes underwent three intravitreal injections of 0.025 mg Fasudil. Best corrected visual acuity (BCVA) and central macular thickness (CMT) were evaluated as the indicators of functional and anatomical response, respectively.
Results: Results: Mean age was 60.1±5.1 (range, 53-68) years and mean number of previous IVB injections was 7.8±2.4 (range 5-10). Five cases responded to treatment; one with anatomical and functional response (CMT: 521 to 395 microns/BCVA:0.3 to 0.1 LogMAR), three with sole functional improvement (BCVA: 0.7 to 0.1; 0.7 to 0.3; and 0.3 to 0.1 LogMAR) and one with sole anatomical improvement (CMT: 390 to 301 microns). Of note, cases without significant CMT change had morphologic improvement of retinal microstructure to some extent. No adverse event was observed during the study period.
Conclusion: Conclusion: Sole injection of intravitreal ROCK inhibitors seems to have moderate visual benefits in eyes with DME refractory to multiple IVB injections. Such effects may be, of course, functionally significant without obvious anatomical improvement.
