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局部应用氯沙坦治疗紫外线 A/核黄素胶原交联术后角膜混浊

Topical Losartan for Treating Corneal Haze After Ultraviolet-A/Riboflavin Collagen Cross-Linking.

机构信息

Whitsett Vision Group, Houston, TX; and.

Department of Ophthalmology, Baylor College of Medicine, Houston, TX.

出版信息

Cornea. 2024 Sep 1;43(9):1165-1170. doi: 10.1097/ICO.0000000000003527. Epub 2024 Mar 22.

Abstract

PURPOSE

The purpose of this study was to report our first clinical experience using topical losartan for the treatment of severe corneal haze after epithelium-off corneal cross-linking (CXL).

METHODS

A 20-year-old man presented with clinically significant corneal haze in the right eye 1 month following Ultraviolet-A/Riboflavin Epithelium-off Collagen CXL. Haze progressed to a deep stromal scar, and vision was 20/150 with no improvement on refraction, 60 days after CXL. After unsuccessful treatment with topical corticosteroids, the patient elected to start off-label treatment with topical losartan 0.8 mg/mL, administered 6 times per day.

RESULTS

After 3 months of initiating topical losartan, the right eye vision improved to preoperative vision of 20/40-1. Corneal haze was significantly reduced as observed on slitlamp examination and on Scheimpflug corneal tomography (Pentacam; OCULUS, Inc. Arlington, WA).

CONCLUSIONS

Topical losartan, a transforming growth factor-β inhibitor, is a potential treatment in clinically significant corneal haze following epithelium-off corneal CXL. This clinical experience highlights the potential efficacy of topical losartan as a novel therapeutic option in such cases, but further clinical studies are needed.

摘要

目的

本研究旨在报告我们使用局部氯沙坦治疗上皮下角膜交联(CXL)后严重角膜混浊的首次临床经验。

方法

一名 20 岁男性在接受紫外线-A/核黄素上皮下胶原 CXL 治疗后 1 个月,右眼出现明显的临床混浊。混浊进展为深层基质瘢痕,CXL 后 60 天,视力为 20/150,无法通过折射提高,治疗 60 天后,局部皮质类固醇治疗无效,患者选择开始局部氯沙坦(0.8mg/ml)的标签外治疗,每天使用 6 次。

结果

开始局部使用氯沙坦 3 个月后,右眼视力提高到术前的 20/40-1。裂隙灯检查和 Scheimpflug 角膜断层扫描(Pentacam;OCULUS,Inc. Arlington,WA)均显示角膜混浊明显减轻。

结论

局部氯沙坦是一种转化生长因子-β抑制剂,是上皮下角膜 CXL 后临床显著角膜混浊的潜在治疗方法。本临床经验强调了局部氯沙坦作为此类病例新的治疗选择的潜在疗效,但需要进一步的临床研究。

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