ESCRS - PO020 - SYSTEMATIC REVIEW OF THE LITERATURE - TOPICAL LOSARTAN OPHTHALMIC DROPS FOR MANAGING CORNEAL HAZE AND POTENTIAL FUTURE INDICATIONS

SYSTEMATIC REVIEW OF THE LITERATURE - TOPICAL LOSARTAN OPHTHALMIC DROPS FOR MANAGING CORNEAL HAZE AND POTENTIAL FUTURE INDICATIONS

Published 2025 - 29th ESCRS Winter Meeting

Reference: PO020 | Type: Presented Poster & Poster | DOI: 10.82333/f4vk-fn97

Authors: Nuno Moura-Coelho* 1 , Mariam Abdelghaffar 2 , José Güell 3

1NOVA Medical School,Lisbon,Portugal;Cornea and Refractive Surgery Unit,IMO Barcelona Grupo Miranza,Barcelona,Spain, 2Royal College of Surgeons in Ireland - School of Medicine,Busaiteen,Bahrain, 3Cornea and Refractive Surgery Unit,IMO Barcelona Grupo Miranza,Barcelona,Spain;Universidad Autonoma de Barcelona,Barcelona,Spain

Purpose

To perform a systematic review of the literature (SR) of all published in-human studies on the use of topical losartan in corneal disease. We also provide insights on the mechanisms of action of transforming growth factor-beta inhibition in the corneal wound healing process.

Setting

Private practice.

Methods

We perfomed a literature review regarding the use of topical losartan in corneal disease in three electronic databases (PubMed, Cochrane Central Register of Controlled Trials [CENTRAL], and ClinicalTrials.gov) using terms related to cornea and losartan in Title/Abstract; hand-search was also performed in reference lists of articles of author publications. The search strategy was last run on October 31st, 2024.

Results

Our SR identified 24 studies, of which 5 were human case reports of the off-label use of topical losartan 0.08% drops for corneal diseases. Three case reports published in peer-reviewed indexed journals, one review article where one case report was described, and a case report in a non-peer-reviewed digital platform. The etiologies of corneal opacity were post-LASIK haze (1), post-crosslinking haze (1), radial keratotomy incision fibrosis (1), post-infectious scar (1) and post-herpes zoster ophthalmicus opacity (1). In all cases, the density of the opacity decreased significantly after topical losartan treatment, with improvemen in visual acuity. No side effects were reported with this topical drug formulation.

Conclusion

The management of corneal haze presents a significant challenge in Ophthalmology, impacting vision and quality of life for patients worldwide. There is an increasing body of pre-clinical evidence and early clinical evidence to suggest the efficacy and safety of topical losartan 0.08% drops for abnormal fibrotic or scarring processes of the cornea. We highlight that findings from our SR consisted only of few case reports, and that controlled clinical trials are needed to ascertain the efficacy and safety of the drug. Advancing our understanding and application of transforming growth factor-beta inhibitors such as losartan for treating cornal opacity could significantly improve patient outcomes.