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Honeycomb epithelial oedema due to ripasudil: clinical, optical coherence tomography and histopathological correlation
  1. Neha Jain1,
  2. Archana Singh2,
  3. Dilip K Mishra3 and
  4. Somasheila I Murthy1
  1. 1Cornea and Anterior Segment Service, LV Prasad Eye Institute, Hyderabad, Telangana, India
  2. 2Department of Cornea and anterior segment, Angel Eyes Institute of Ophthalmology, Kanpur, Uttar Pradesh, India
  3. 3Ophthalmic Pathology Service, LV Prasad Eye Institute, Hyderabad, Telangana, India
  1. Correspondence to Dr Somasheila I Murthy; smurthy{at}


A male in his 50s, who had undergone Descemet’s stripping automated endothelial keratoplasty (DSAEK) for corneal oedema following irido-corneal-endothelial syndrome and glaucoma drainage device surgery for secondary glaucoma presented with gradual decreased vision. The patient was on ripasudil 0.4% for the past 4 months prior to the presentation. Honeycomb epithelial oedema was seen with vesicles and intraepithelial microcyst formation which were also noted on anterior segment optical coherence tomography (OCT) and histopathology, that co-related with the slit-lamp findings. The patient underwent repeat DSAEK and had a good outcome. While the clinical features and OCT findings have been reported earlier, the histopathological features have not been reported.

  • eye
  • ophthalmology

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  • Contributors The case was managed by SIM and AS. NJ and SIM drafted the manuscript and SIM designed the images. DKM provided pathology support. Final draft was done by SIM, DKM and AS.

  • Funding This study was funded by Hyderabad Eye Research Foundation (Grant number: LEC-BHR-R-05-22-875).

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.