Manejo de las úlceras corneales neurotróficas con Cacicol®- ReGeneraTing Agent: serie de casos / Management of corneal neurotrophic ulcers with Cacicol®-RGTA (ReGeneraTing Agent): a case series

OBJETIVO: Las úlceras corneales neurotróficas son difíciles de tratar y las terapias convencionales fracasan con frecuencia. Un nuevo agente regenerativo de la matriz extracelular («ReGeneraTing Agents»), Cacicol® (Laboratoires Théa), ha demostrado buenos resultados en los últimos años. El objetivo de este estudio fue evaluar la respuesta a Cacicol® en una serie de casos con úlceras corneales neurotróficas. MÉTODOS: Serie de casos retrospectiva. Once pacientes con úlceras corneales neurotróficas que no respondieron a una terapia convencional fueron tratados con Cacicol®. Un ciclo incluyó una gota cada 2 días durante 5 días. RESULTADOS: El rango de duración de la terapia convencional, previa al comienzo del tratamiento con Cacicol® fue 0 a 91 días. Tras introducir Cacicol® el 82% (9/11) de los casos se curaron y el 18% (2/11) no lo hicieron, llegando a requerir un trasplante de membrana amniótica o una queratoplastia penetrante, respectivamente. El 67% (6/9) de los pacientes curados requirieron solo un ciclo de Cacicol® y el 45% (5/11) pacientes necesitaron más de un ciclo. Un caso de úlcera corneal bacteriana respondió favorablemente pero un caso infectado por Acanthamoeba fracasó. En la mayoría de los pacientes, la agudeza visual mejoró o se mantuvo. CONCLUSIÓN: Cacicol® resultó una terapia exitosa en una alta proporción de úlceras neurotróficas, incluidas las infecciosas. Algunos casos requieren más de un ciclo de Cacicol® o su uso como primer línea de tratamiento

PURPOSE: Neurotrophic corneal ulcers are difficult to treat, and the conventional treatment often results in failure. A new matrix regenerating agent ("ReGeneraTing Agents"), Cacicol® (Laboratoires Théa), has demonstrated good results over the last few years. Therefore, the aim of this study was to evaluate the response to Cacicol® in a series of cases with neurotrophic corneal ulcers. METHODS: Retrospective case series looking at 11 patients with corneal ulcers unresponsive to conventional therapy that underwent treatment with Cacicol®. One cycle included 1 drop every two days for 5 days. RESULTS: The range of conventional therapy prior to Cacicol® was 0-91 days. On introducing Cacicol® 82% (9/11) of the cases were cured, and 18% (2/11) failed, requiring an amniotic membrane transplant or penetrating keratoplasty. The healing only required one cycle of Cacicol® in 67% (6/9) of the patients. More than one cycle of Cacicol® was needed in 45% (5/11) patients. One corneal bacterial ulcer responded favourably and one case related to Acanthamoeba did not respond. Most of the patients improved or maintained their visual acuity. CONCLUSION: Cacicol® was a useful therapy in a high number of difficult neurotrophic corneal ulcers, including corneal infections. Some cases may require more than one cycle of Cacicol® or used as first-line treatment in order to achieve the desired result

Management of corneal neurotrophic ulcers with Cacicol®-RGTA (ReGeneraTing Agent): a case series. / Manejo de las úlceras corneales neurotróficas con Cacicol®- ReGeneraTing Agent: serie de casos.

PURPOSE: Neurotrophic corneal ulcers are difficult to treat, and the conventional treatment often results in failure. A new matrix regenerating agent ("ReGeneraTing Agents"), Cacicol® (Laboratoires Théa), has demonstrated good results over the last few years. Therefore, the aim of this study was to evaluate the response to Cacicol® in a series of cases with neurotrophic corneal ulcers. METHODS: Retrospective case series looking at 11 patients with corneal ulcers unresponsive to conventional therapy that underwent treatment with Cacicol®. One cycle included 1 drop every two days for 5 days. RESULTS: The range of conventional therapy prior to Cacicol® was 0-91 days. On introducing Cacicol® 82% (9/11) of the cases were cured, and 18% (2/11) failed, requiring an amniotic membrane transplant or penetrating keratoplasty. The healing only required one cycle of Cacicol® in 67% (6/9) of the patients. More than one cycle of Cacicol® was needed in 45% (5/11) patients. One corneal bacterial ulcer responded favourably and one case related to Acanthamoeba did not respond. Most of the patients improved or maintained their visual acuity. CONCLUSION: Cacicol® was a useful therapy in a high number of difficult neurotrophic corneal ulcers, including corneal infections. Some cases may require more than one cycle of Cacicol® or used as first-line treatment in order to achieve the desired result.

Optic neuropathy secondary to syphilis in an HIV negative patient.

Ocular syphilis is a resurgent clinical condition due to unsafe sexual practices. It has been reported in both immunocompromised and immunocompetent patients, but in HIV positive patients, it is more likely to exhibit a more aggressive course and adopt atypical clinical patterns such as optic nerve involvement. Herein we report an atypical case of optic neuritis secondary to syphilis in an HIV negative patient. This case highlights the importance of considering syphilis in the differential diagnosis of ocular inflammation and of obtaining HIV serology, since both diseases share common risk factors.