Omidenepag isopropyl (OMDI) represents an advancement in glaucoma therapeutics as a selective EP2 receptor agonist. Its primary clinical advantage lies in its potent intraocular pressure (IOP) reduction without the prostaglandin F (FP) receptor–mediated adverse effects, such as prostaglandin-associated periorbitopathy, which can limit the tolerability of traditional prostaglandin analogues (PGAs).

The recent case series by Cheng et al¹ makes a contribution to our understanding of OMDI-associated retinal complications. Previously reported adverse effects of EP2 receptor agonists encompass conjunctival hyperemia and irritation, dry eye, punctate keratitis, corneal thickening, and headache, with conjunctival hyperemia being the most common ocular adverse effect.² OMDI received approval in Japan in 2018 and subsequently in the US in 2022 for the treatment of ocular hypertension and open-angle glaucoma.