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Twenty-six eyes of 21 client-owned dogs with PCED were enrolled in a prospective, randomized, vehicle control clinical trial and received topical netarsudil 0.02% (Rhopressa\u00ae) or vehicle control twice daily (BID) for the first 4\u00a0months. Then, all patients received netarsudil for the next 4 or 8\u00a0months. Complete ophthalmic examination, ultrasonic pachymetry<jats:italic>,<\/jats:italic> Fourier-domain optical coherence tomography, and in vivo confocal microscopy were performed at baseline and 1, 2, 4, 6, 8 and 12\u00a0months. Effect of netarsudil on central corneal thickness (CCT), percentage of cornea with edema, and endothelial cell density (ECD) were evaluated by repeated measures ANOVA. Kaplan\u2013Meier curves and log-rank test were used to compare corneal edema and clinical progression of eyes in netarsudil versus vehicle control groups. All dogs developed conjunctival hyperemia in at least one eye while receiving netarsudil. Unilateral transient reticulated intraepithelial bullae and stromal hemorrhage were observed respectively in 2 dogs in the netarsudil group. Two dogs showed persistently decreased tear production while receiving netarsudil, requiring topical immunomodulatory treatment. No significant differences in CCT, ECD, corneal edema or clinical progression were observed between netarsudil or vehicle treated eyes. When comparing efficacy of topical netarsudil BID and topical ripasudil 0.4% administered four times daily from our previous study, dogs receiving ripasudil had significantly less progression than those receiving netarsudil.<\/jats:p>","DOI":"10.1038\/s41598-024-56084-4","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T21:24:39Z","timestamp":1710451479000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Topical netarsudil for the treatment of primary corneal endothelial degeneration in dogs"],"prefix":"10.1038","volume":"14","author":[{"given":"M. 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