Use Of Topical Losartan 0.08% Eyedrops For The Treatment Of Non-Surgical Post-Infectious Corneal Haze In A Child And An Adult.

The purpose of this ongoing study is to describe the results of topical losartan 0.08% administration and its effect in non-surgical post-infectious corneal haze in a thirteen-year-old male with sub-epithelial corneal infiltrates secondary to adenoviral conjunctivitis and in a sixty-two-year-old male with a herpetic leukoma after six months of treatment.

The study is conducted on two eyes of two patients in a tertiary university hospital in Madrid, Spain, in January 2025 and will be finished in July 2025. Informed consent was obtained from the adult patient and from the legally designated representative in the minor for the off-label use of topical losartan.

The first patient was a 13-year-old male referred to the cornea clinic because of blurry vision and photophobia after an adenoviral conjunctivitis.

Best corrected visual acuity (BCVA) was 0.5 for the right eye (RE) and 1.0 for the left eye. Slit-lamp examination of the RE revealed sub-epithelial infiltrates and a paracentral leukoma. A combined therapy of topical losartan 0.8 mg/ml (0.08%) 6 times per day and topical ciclosporin 0.1% q.d. was used. The second patient was a 62-year-old male with a history of recurrent herpetic keratitis of the RE. BCVA was 0.4. A paracentral nasal leukoma on slit-lamp examination was revealed. Combined therapy of losartan 0.08% six times per day, fluorometholone and oral prophylactic valacyclovir were used.  

The patients underwent a complete ophthalmological examination that included a slit-lamp evaluation of the anterior segment, intraocular pressure (IOP) measurement and fundoscopy in the baseline visit. Best-corrected visual acuity (BCVA) was also assessed. Multimodal image techniques including corneal tomography, anterior-segment optical coherence tomography (AS-OCT) and slit-lamp photographs were also performed.

Follow-up appointments at one month, three and six months were scheduled and a full examination was conducted. We would report the effect of topical losartan in the density of the leukomas and how it affected patient vision subjectively.

The findings from these two cases can illustrate the potential use of topical losartan for the treatment of corneal haze in selected cases after infectious keratitis.