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Regenerative therapy for post-herpetic neurotrophic ulcer

Poster Details

First Author: R.Hristova BULGARIA

Co Author(s):    I. Tanev   G. Markov   M. Hristova   V. Haykin           

Abstract Details


To assess the application of regenerative therapy (RGTA-Cacicol) in a case of chronic neurotrophic ulcer after herpes zoster ophthalmicus in an 80-year woman with complaints of reduced visual acuity, pain, redness and tearing in her left eye for 1 year and 3 months. The patient received topical and systemic treatment for herpes zoster 1.5 years before presentation to our clinic.


Department of Ophthalmology, University Hospital Alexandrovska


Upon examination visual acuity was VOD=0.6, VOS=0.15, IOP was within normal limits, corneal sensation was absent in the left eye. Biomicroscopy revealed a 3x5mm paracentral corneal ulcer with pooling of fluorescein in the defect and irregular stromal thickness. AS-OCT was performed to characterize the loss of epithelium, stromal thinning and hyperreflectivity in the area of the defect. After failure of multiple topical medication regiments, the patient was referred for treatment with regenerative therapy (RGTA-Cacicol).


Based on the clinical findings the patient was diagnosed with neurotrophic ulcer of the left eye due to herpes zoster ophthalmicus. The condition did not improve after discontinuation of all potentially toxic topical medications. Complete epithelialization of the corneal defect, cessation of stromal thinning and improvement of visual acuity were achieved after four applications of topical Cacicol once a week. AS-OCT after treatment demonstrated reduced stromal hyperreflectivity and restored integrity of the epithelium.


Successful treatment of neurotrophic ulcers relies on a quick diagnosis, adequate treatment with reduced number of potentially toxic topical medications and sufficient lubricants, as well as specifically targeted therapeutic options. One of them is regenerative therapy (RGTA-Cacicol), which is an effective alternative for topical treatment of neurotrophic ulcers.

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