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

Purpose: To present the clinical, topographic, and densitometry outcomes of patients with corneal fibrosis treated with topical losartan.

Methods: In this case series, patients with corneal scars treated with topical losartan 0.8 mg/mL 4 times a day for 6 months were included. Age, sex, cause of corneal opacity, months with corneal opacity, and previous topical treatment were recorded. Patients were examined at baseline and 1, 3, and 6 months after starting treatment. At each visit, uncorrected and best-corrected visual acuity, subjective refraction, intraocular pressure, slit-lamp examination, corneal tomography, and densitometry were performed. Patients were asked about drop comfort and possible side effects on a 0 to 10 self-reported scale.

Results: Eight eyes of 7 patients (4 males, 3 females, mean age 45.1 ± 12.0 years) were included. Best-corrected visual acuity logMAR was 0.28 ± 0.17 pretreatment and 0.17 ± 0.11 after 6 months of topical losartan (P = 0.358). The visual acuity of 5 eyes improved, 1 eye remained unchanged, and the vision of 2 eyes declined. No changes in topographic and densitometry parameters were noted within the cohort analyzed as a group (all P > 0.05). No systemic side effects were reported, and tolerance was from very good to excellent (all 2/10 or better).

Conclusions: No significant improvements in visual acuity and densitometry values were noted with topical losartan in this series analyzed as a group. Further research to assess the full scope of clinical applications in corneal fibrosis is needed, particularly randomized clinical trials to address the effect of time and unequivocally prove its beneficial effects.