June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
NEW REGENERATING AGENTS FOR OCULAR SURFACE: A NEUROTROPHIC KERATITIS CASE SERIES.
Author Affiliations & Notes
  • Ana María Muñoz Hernández
    HOSPITAL CLINICO SAN CARLOS DE MADRID (SPAIN), MADRID, Spain
  • Enrique Santos-Bueso
    HOSPITAL CLINICO SAN CARLOS DE MADRID (SPAIN), MADRID, Spain
  • Ricardo Cuiña-Sardiña
    HOSPITAL CLINICO SAN CARLOS DE MADRID (SPAIN), MADRID, Spain
  • David Díaz-Valle
    HOSPITAL CLINICO SAN CARLOS DE MADRID (SPAIN), MADRID, Spain
  • José Antonio Gegúndez-Fernández
    HOSPITAL CLINICO SAN CARLOS DE MADRID (SPAIN), MADRID, Spain
  • Jose M Benitez Del Castillo
    HOSPITAL CLINICO SAN CARLOS DE MADRID (SPAIN), MADRID, Spain
  • Footnotes
    Commercial Relationships   Ana María Muñoz Hernández, None; Enrique Santos-Bueso, None; Ricardo Cuiña-Sardiña, None; David Díaz-Valle, None; José Antonio Gegúndez-Fernández, None; Jose Benitez Del Castillo, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1389. doi:
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      Ana María Muñoz Hernández, Enrique Santos-Bueso, Ricardo Cuiña-Sardiña, David Díaz-Valle, José Antonio Gegúndez-Fernández, Jose M Benitez Del Castillo; NEW REGENERATING AGENTS FOR OCULAR SURFACE: A NEUROTROPHIC KERATITIS CASE SERIES.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1389.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The aim of this study was to evaluate the effectiveness of Cacicol® (RGTA® or ReGeneraTing Agent), a matrix regeneration therapy, in 10 cases of neurotrophic keratitis (NK). Conventional treatments are often unsatisfactory and specific medical treatment is necessary for this corneal pathology. As a consequence, extensive research is being developed in this field.

Methods : An uncontrolled, prospective and interventional case series was performed on 10 patients (10 eyes) with corneal NK with torpid evolution. These patients were treated with Cacicol® (Laboratoires Théa, Clermont-Ferrand, France) with a dose of 1 drop every 48 hours. The treatment was discontinued when epithelization was complete or, in some cases when no more improvement was expected.

Results : Ten patients (10 eyes) were treated: 7 females and 3 males between 31 and 95 years of age. They presented NK with an evolution time range of 2 weeks to 12 months. Previous treatments that the patients received during that period included artificial tears and ointments, autologous serum drops, anti-inflammatory drops, oral and/or topics antibiotics and antiviral drugs, contact bandages and punctual occlusion. After starting the Cacicol® treatment, 9 of 10 eyes were completely healed of NK. The epithelization time was 7 to 90 days. Only one patient presented incomplete healing, but she showed more than 50% improvement.
None of the patients needed surgical treatment, and none of them had local or systemic adverse effects or intolerance to Cacicol®.

Conclusions : NK is a corneal pathology with frequently irregular response to the conventional treatments. Cacicol® is a polymer (carboxymethyl cellulose sulfate) that belongs to matrix regenerating agents (RGTA®) and mimics heparan-sulfate of the extracellular corneal matrix. This drug acts on the damaged tissue by providing structural support and giving stability to heparin-binding growth factors and matrix proteins, protecting them from proteolytic enzymes. Our study shows the effectiveness of this promising new alternative treatment for NK, and in some cases, it could possibly avoid the necessity of surgical treatment.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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