Ripasudil Eyedrops Ameliorated Bullous Keratopathy Complicated with Cytomegalovirus Corneal Endotheliitis: A Case Report

ABSTRACT

Purpose

We describe a case of bullous keratopathy complicated with cytomegalovirus (CMV) corneal endotheliitis that was successfully treated with ripasudil eye drops.

Methods

A retrospective case report.

Results

A 65-year-old female patient diagnosed with CMV-associated anterior uveitis in the right eye was referred to us when anterior uveitis recurred with bullous keratopathy. Initial best-corrected visual acuity (BCVA) was 0.4 (decimal visual acuity). Her condition did not improve with anti-CMV treatment, and BCVA decreased to 0.07. At this point, intraocular pressure (IOP) was 20 mmHg, and ripasudil eye drops were started for IOP control. After 1 month, not only had IOP decreased to 14 mm Hg but the condition of the corneal edema had also improved. The central corneal thickness decreased to a normal level, and the BCVA recovered to 0.8.

Conclusion

Ripasudil eye drops not only lower IOP in patients with CMV corneal endotheliitis but may also have the potential to treat bullous keratopathy.

KEYWORDS:

• Bullous keratopathy
• Corneal endotheliitis
• cytomegalovirus
• ripasudil
• rock inhibitors

Acknowledgments

The authors thank Mr. Tim Hilts for reviewing this manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

This study was approved by the Institutional Review Board of Tohoku University Hospital (No. 22440) and was conducted in accordance with the tenets of the Declaration of Helsinki. Written informed consent was obtained for publication by the patient.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.