Arvola Riku P J, Robciuc Alexandra, Holopainen Juha M
*Helsinki Eye Lab, Department of Ophthalmology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland; and †Genomics and Biomarkers Unit, National Institute for Health and Welfare, Helsinki, Finland.
Cornea. 2016 Apr;35(4):451-5. doi: 10.1097/ICO.0000000000000759.
Treating corneal neurotrophic ulcers is challenging. Topical application of matrix regeneration therapy (RGTA), which is a dextran derivative polymer and heparan sulfate analog, is a promising regenerative therapy and an alternative or additional therapeutic regimen when corneal healing is compromised. The aim of this study was to evaluate the efficacy of RGTA (Cacicol) in the treatment of 6 patients with severe neurotrophic ulcers.
We present an uncontrolled prospective case series of 6 patients (6 eyes) with severe corneal neurotrophic ulcers. Patients were treated with topical RGTA at a dose of 1 drop every second day. The main outcome measure was complete corneal epithelialization. We measured corneal thickness by anterior segment swept-source optical coherence tomography.
Two patients (33%) showed complete corneal healing, one at 6 weeks and the other at 10 weeks. Treatment was considered failure in 4 patients (67%), and 1 patient had corneal perforation. None of the patients showed improvement in best-corrected visual acuity. There were no RGTA-related local or systemic side effects.
Based on previous studies, RGTA seems to be a promising therapeutic agent for controlling ocular surface inflammation and promoting corneal healing. In this study, the efficacy of RGTA did not match the encouraging results from previous reports.
治疗角膜神经营养性溃疡具有挑战性。基质再生疗法(RGTA)是一种葡聚糖衍生物聚合物和硫酸乙酰肝素类似物,局部应用是一种有前景的再生疗法,在角膜愈合受损时可作为一种替代或辅助治疗方案。本研究的目的是评估RGTA(Cacicol)治疗6例严重神经营养性溃疡患者的疗效。
我们呈现了一个非对照前瞻性病例系列,共6例(6只眼)严重角膜神经营养性溃疡患者。患者接受局部RGTA治疗,剂量为每两天1滴。主要观察指标是角膜上皮完全化。我们通过眼前节扫频光学相干断层扫描测量角膜厚度。
2例患者(33%)角膜完全愈合,1例在6周时愈合,另1例在10周时愈合。4例患者(67%)治疗失败,1例患者发生角膜穿孔。所有患者的最佳矫正视力均未改善。未观察到与RGTA相关的局部或全身副作用。
基于先前的研究,RGTA似乎是控制眼表炎症和促进角膜愈合的一种有前景的治疗药物。在本研究中,RGTA的疗效与先前报告中的令人鼓舞的结果不相符。