Fuchs' Endothelial Dystrophy Clinical Trial
Official title:
Prospective Single-centre Randomized Observer-blind Placebo-controlled Parallel-group Phase IIa Clinical Trial to Investigate the Safety and Efficacy of Ripasudil 0.4% Eye Drops After Descemetorhexis in Patients With Moderate to Advanced Fuchs Endothelial Corneal Dystrophy (FECD)
The cornea forms our "window to the world". Hence, its transparency is of utmost importance
for vision. Corneal endothelium plays a central role in the maintenance of a transparent
corneal stroma. It limits stromal fluid uptake from the anterior chamber of the eye through
the formation of tight junctions. Simultaneously, fluid is actively transported from corneal
stroma into the anterior chamber. This maintains the corneal stroma in a state of relative
dehydration, thereby ensuring a constant distance of stromal collagen lamellae to each other,
which in turn forms the basis for transparency of this tissue. If however corneal endothelial
function is impaired, stromal swelling leads to corneal clouding and loss of vision.
Fuchs endothelial corneal dystrophy represents the most common form of corneal dystrophy. It
occurs sporadically, however in some cases autosomal dominant inheritance has been described.
This condition leads to progressive loss of corneal endothelium (typically around the age of
50-60 years), causing visual impairment due to swelling and opacification of corneal stroma.
Cell culture experiments have been able to show that chemical inhibitors of Rho-Kinase
promote corneal endothelial cell proliferation and reduce apoptosis, while topical
application in an animal model promoted corneal endothelial wound healing. This has prompted
the notion of using topical Rho-kinase-inhibitor treatment to support endothelial cell
regeneration in Fuchs endothelial corneal dystrophy.
Since September 2014, Rho-kinase-inhibitor eye drops (ripasudil) are clinically available in
Japan for reduction of intraocular pressure in Glaucoma patients. Ripasudil eye drops
therefore represent a strong candidate for safe and effective adjunctive treatment in
patients with Fuchs corneal endothelial cell dystrophy.
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