University of Maryland, Baltimore
The goal of this clinical trial is to compare participants treated with latanoprost to those treated with Rocklatan (netarsudil/latanoprost) to determine whether the addition of netarsudil results in greater improvements in episcleral venous blood flow in adults with glaucoma or ocular hypertension. Episcleral venous blood flow will be measured using erythrocyte-mediated angiography (EMA) and laser speckle contrast imaging (LSCI). The main questions this study aims to answer are: * Does Rocklatan produce greater increases in episcleral venous blood flow than latanoprost alone? * Can EMA and LSCI reliably detect changes in episcleral venous blood flow following treatment with these medications? Participants will: * Be randomized to receive either latanoprost or Rocklatan * Undergo imaging of the episcleral veins using EMA and LSCI before, during, and after treatment, and * Complete study visits that include standard ophthalmic examinations and intraocular pressure measurements. Hypothesis: The investigators hypothesize that latanoprost, which primarily increases uveoscleral outflow, will not significantly affect the distal episcleral circulation. In contrast, Rocklatan, through its netarsudil component, is expected to produce measurable increases in episcleral venous flow.
Glaucoma is a leading cause of irreversible blindness worldwide, and lowering intraocular pressure (IOP) remains the primary strategy for slowing disease progression. While many glaucoma medications reduce IOP by increasing aqueous humor outflow or decreasing its production, the effects of these therapies on the distal conventional outflow pathway-particularly the episcleral venous circulation-are not well understood. Previous studies using erythrocyte-mediated angiography (EMA)-a novel imaging technique capable of directly quantifying episcleral venous blood flow in vivo-demonstrated that net…
Inclusion: * Patients are at least 18 years of age. * Patients must have ocular hypertension or be a glaucoma suspect. * Patient must not have used any IOP-lowering medication (topical or systemic) within the past 6 months * Patients must have open angles on gonioscopy. * All patients will have at least one recorded visual field examination within 6 months of enrollment in the study. Visual fields will be assessed using the Hodapp-Andersen-Parish criteria. Exclusion: * Participation in other investigational studies, unless such participation does not involve the administration of any drugs…
Rocklatan (Netarsudil 0.02%/ latanoprost 0.005) one drop nightly for 14-28 days, if randomized to Rocklatan after 28-35 days on Latanoprost.
Latanoprost 0.005% one drop nightly for 28-35 days, then 14-28 days if randomized to continue on latanoprost.