Title : Acute anterior uveitis induced by omidenepag isopropyl (Eybelis): A case report and literature review
Abstract:
Purpose: Omidenepag Isopropyl, a non-prostaglandin selective EP2 receptor agonist, has been shown to effectively lower intraocular pressure (IOP) in glaucoma patients by increasing aqueous outflow through both conventional and uveoscleral pathways. First introduced in Japan in 2018, most adverse reactions were reported primarily in clinical trials. The aim of this study is to present a real-world case of acute anterior uveitis (AAU) induced by Omidenepag Isopropyl and explore the potential mechanisms behind this adverse event.
Methods: This is a case report with a retrospective analysis of medical records. Comprehensive ocular examinations were performed in the ophthalmology department, including visual acuity tests, slit-lamp biomicroscopy, and fundus examination.
Results: A 52-year-old male with a long-standing history of primary open-angle glaucoma (OU) since 2015 was previously treated with various topical medications, including Bimatoprost and Carteolol. His visual acuity was 1.0 (OU). After switching to Omidenepag Isopropyl (Eybelis), the patient developed blurred vision (OU) and clinical signs of acute anterior uveitis (OU). Upon examination, his visual acuity with corrective lenses was 0.6 in the right eye and 0.4 in the left eye. Slit-lamp biomicroscopy revealed conjunctival hyperemia and 2+ cells in the anterior chamber (OU). The fundus examination was unremarkable. Eybelis was discontinued, and anti-inflammatory therapy was initiated alongside a switch back to Bimatoprost and Carteolol for glaucoma management. At the 1-month follow-up, the patient’s visual acuity had returned to 1.0 (OU), and the anterior chamber inflammation had resolved.
Conclusion: This case underscores the potential risk of acute anterior uveitis with the use of Omidenepag Isopropyl in glaucoma treatment. While the drug effectively lowers IOP, it may trigger ocular inflammation in susceptible individuals. Early recognition of this adverse effect, prompt discontinuation of the medication, and appropriate anti-inflammatory treatment are critical in preventing vision-threatening complications. Further research is needed to better understand the mechanisms by which Omidenepag Isopropyl induces uveitis and to identify risk factors that may predispose patients to this reaction.
