Topical Losartan for Corneal Fibrosis: A Case Series With Densitometry Analysis

Area of Science:

• Ophthalmology
• Corneal Diseases
• Pharmacology

Background:

• Corneal fibrosis, a leading cause of vision loss, results from scar tissue formation.
• Current treatments for corneal fibrosis have limited efficacy.
• Topical losartan, an angiotensin II receptor blocker, is being investigated for its potential antifibrotic properties.

Purpose of the Study:

• To evaluate the clinical, topographic, and densitometry outcomes of patients with corneal fibrosis treated with topical losartan.
• To assess the safety and tolerability of topical losartan in this patient population.

Main Methods:

• A case series of 7 patients (8 eyes) with corneal scars treated with topical losartan 0.8 mg/mL four times daily for 6 months.
• Evaluations included visual acuity, refraction, intraocular pressure, slit-lamp examination, corneal tomography, and densitometry at baseline and 1, 3, and 6 months.
• Patient-reported outcomes on drop comfort and side effects were also recorded.

Main Results:

• No statistically significant improvement in best-corrected visual acuity (BCVA) was observed (0.28 ± 0.17 pre-treatment vs. 0.17 ± 0.11 post-treatment, P = 0.358).
• While 5 eyes showed improved vision, 2 experienced decline.
• Corneal tomography and densitometry parameters showed no significant group changes.
• Topical losartan was well-tolerated with no reported systemic side effects.

Conclusions:

• Topical losartan did not demonstrate significant improvements in visual acuity or corneal densitometry in this cohort.
• Further investigation, including randomized clinical trials, is warranted to explore the efficacy of topical losartan for corneal fibrosis.
• The potential benefits of topical losartan for corneal fibrosis require more robust evidence.