Abstract
Purpose :
Corneal neovascularization is secondary to different conditions such as herpes simplex stromal keratitis, persistent corneal epithelial defects, contact lens use, keraoplasty or infections. The compact architecture of the stromal tissue is considered an impediment to vessel invasion. Several studies have suggested an association of corneal scarring and neovascularization with cytoskeletal regulator. Regenerating Agents ( RGTA) is a new treatment that mimics the function of extracellular matrix components. It makes extracellular matrix resistant to inflammatory molecules, restoring the properties and the micro-environment needed for the normal corneal tissue regeneration. We report number of cases showing the role of Cacicol® in the regression of severe corneal neovascularization.
Methods :
Interventional number of cases ( N=5 ) treated with RGTA ( Cacicol®) for two months. The patients presented central corneal epithelial defect caused by neurotrophic keratopathy. These defects showed superficial and deep stromal neovascularization. The etiologies were herpes simplex, facial paralysis and infection.These were treated with conventional therapy which included artificial tears, topic moxifloxacin three times daily, fluorometolone 1mg/ml one time daily and therapeutic contact lens use. In two patients, we included 20% autologous serum three times daily. No improvement of the pathology was achieved after four weeks. We decided to combine this conventional treatment with Cacicol® once every two days for one month. After that period, we spread the dose to once a week for one month more.
Results :
After first month, we observed that the dimensions of the epithelial defect decreased in two cases and it had dissapeared in three cases. After second month, all patients had complete corneal healing and we also observed a regression of superficial and deep stromal vascularization. In three cases, neovascularization had decreased considerably and it had dissapeared in two cases.
Conclusions :
RGTA ( Cacicol®) improves corneal melting and epithelial defects associated to corneal neurotrophic pathology. Moreover, in cases with corneal neovascularization associated, we find an important decrease of superficial and deep neovessels. Therefore, this new therapeutic effect of RGTA ( Cacicol®) should be considered for the treatment of corneal neovascularization.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.