Compared with PGA alone, rocklatan provides what?

• A. It acts exactly like PGA with the same MOA.
• B. It acts only by reducing EVP.
• C. It acts only by increasing outflow through TM.
• D. It combines increasing TM outflow, reducing EVP, and decreasing aqueous humor production.

Answer: (D)

Rocklatan combines a prostaglandin analog with a ROCK inhibitor, so it lowers intraocular pressure by several complementary paths. The prostaglandin component (latanoprost) mainly boosts outflow through the uveoscleral pathway. The ROCK inhibitor (netarsudil) relaxes the trabecular meshwork to increase TM outflow and also lowers episcleral venous pressure, which reduces the backpressure on drainage pathways. When you put these together, you get more drainage through both the trabecular meshwork and the uveoscleral routes, plus a reduction in EVP that enhances overall outflow. There’s also a contribution to lowering aqueous humor production, adding a third mechanism. So the overall effect is a combination of increasing TM outflow, reducing EVP, and decreasing production, which is why this option best describes rocklatan’s action compared with PGA alone.