ABSTRACT
Background: Persistent anosmia following COVID-19 disease affects a significant subset of patients. Symptoms of this olfactory dysfunction negatively impact patient quality of life, and effective treatments are lacking; therefore, novel therapies that restore the ability to smell have tremendous clinical potential. Case report: A 46-year-old female enrolled in a phase I clinical trial to assess the safety of targeted intranasal administration of a novel acellular secretome therapy (ST266) in patients diagnosed as glaucoma suspects. The patient reported greater than one year history of loss of smell that started following a presumed positive case of COVID-19. Following a 28-day treatment course of bilateral intranasal administration of ST266, the patient had resolution of her long-standing anosmia. Conclusion: This case demonstrates resolution of COVID-19-induced persistent anosmia after intranasal treatment with a novel acellular secretome therapy. Further studies are warranted to determine the potential of ST266 and its components to treat anosmia.
ABSTRACT
PURPOSE: To report 2 cases with a novel finding of bullous epithelial keratopathy associated with netarsudil use. OBSERVATIONS: A 72-year-old man with history of primary open angle glaucoma was started on netarsudil daily in both eyes for uncontrolled intraocular pressures despite treatment with latanoprost, brimonidine, and dorzolamide-timolol. One month later he presented with bilateral conjunctival hyperemia, predominantly inferior corneal epithelial bullae, and keratic precipitates without hypopyon. Netarsudil was discontinued, and the patient was started on topical steroids. One week later, the hyperemia and corneal edema had resolved while many small keratic precipitates persisted.A 29-year-old man with history of rubella-associated glaucoma and chronic postoperative inflammation on prednisolone was started on netarsudil in his left eye only for elevated intraocular pressures despite latanoprost, brimonidine, and dorzolamide-timolol. Two months later, he complained of eye pain and decreased vision since starting netarsudil. Examination revealed mild hyperemia and inferior corneal epithelial bullae without keratic precipitates. Netarsudil was discontinued, and two weeks later, conjunctival injection resolved and cornea cleared. CONCLUSIONS AND IMPORTANCE: Netarsudil ophthalmic solution 0.02% (Rhopressa) is a rho-kinase inhibitor recently approved for lowering intraocular pressure in open-angle glaucoma or ocular hypertension. As netarsudil continues to be increasingly used, physicians and patients need to be aware of this new possible adverse effect.