A Scoping Review of Rho Kinase Inhibitors and their Role in Glaucoma Treatment.

Abstract

Objective: The purpose of this scoping review is to provide researchers with a comprehensive knowledge map and identify existing knowledge gaps.

Introduction: Glaucoma is the leading cause of irreversible blindness worldwide. ROCK inhibitors are a novel class of intraocular pressure-lowering drugs that specifically target trabecular meshwork cells. Current research on ROCK inhibitors is dispersed across multiple directions, and their precise mechanisms of action in glaucoma treatment remain incompletely understood. For these reasons, we sought to integrate the existing evidence using a scoping review approach.

Methods: Relevant articles published between 2014 and 2024 were identified and screened using keywords in the PubMed and Embase databases. Articles were analyzed based on the inclusion and exclusion criteria.

Results: The collected studies were categorized into three main themes: intraocular pressure reduction, neuroprotection, and anti-fibrosis. A total of 23 articles were included in the review. We found that studies related to intraocular pressure reduction accounted for the majority (approximately 74%), while research on neuroprotection and anti-fibrosis was relatively limited (approximately 14% each). Furthermore, among the 23 included articles, only one was a systematic review or meta-analysis.

Conclusion: ROCK inhibitors directly act on the trabecular meshwork to lower IOP and have potential neuroprotective and anti-fibrotic effects. However, these potential effects require further clinical trials to validate their efficacy in humans. In the future, more systematic reviews and meta-analyses are also needed to integrate and summarize the current primary research findings.