In a recent publication in “Ophta,” Dr. Emilio Torres-Netto, Prof. Dr. Farhad Hafezi, and Dr. Mark Hillen present a review on the application of a well-established antihypertensive medication, losartan, for treating corneal opacities.
Corneal opacities often arise post eye surgeries or injuries due to the activation and proliferation of myofibroblasts during the wound healing process. These cells, characterized by low crystalline protein levels and a disorganized extracellular matrix, contribute significantly to haze formation, thereby diminishing corneal transparency. This cellular response is primarily driven by cytokines such as transforming growth factor-beta (TGF-b) and platelet-derived growth factor (PDGF), which promote myofibroblast differentiation and persistence, particularly following corneal injury or surgery.
To counteract haze formation during surgical procedures, surgeons employ mytomycin-C (MMC), an antiproliferative agent that inhibits the proliferation of keratocytes into myofibroblasts, thus maintaining corneal clarity by preventing the development of fibrosis and scar tissue. However, MMC’s effectiveness is limited to preemptive application during surgery and is less beneficial for treating existing corneal opacities caused by other factors like injuries.
Losartan emerges as a promising therapeutic option in these cases due to its ability to inhibit TGF-b signaling, potentially preventing the differentiation of myofibroblasts and offering a novel approach to treating corneal opacities. The review highlights the potential of topical losartan application as an innovative treatment that could supplement or even provide an alternative to current methods, such as excimer laser removal of opaque tissue or, in severe cases, corneal transplant surgery, for restoring vision in patients with corneal opacities. There is increasing experimental evidence, and now clinical experience, of using topical formulations of losartan for the treatment of corneal opacities. This looks to be a promising avenue for the treatment of corneal opacities, particularly those that arise as a result of injuries, which are currently very hard to treat.
Reference
Torres-Netto, E., Hafezi, F., & Hillen, M. (2024). Topical Losartan in Corneal Opacities. Ophta, 2, 2-4. Publisher: IMK Institut für Medizin und Kommunikation AG
