Management of herpes zoster neurotrophic ulcer using a new matrix therapy agent (RGTA): A case report

• Published in: Journal francais d'ophtalmologie Vol. 35; no. 3; p. 187.e1
• Main Authors: De Monchy, I, Labbé, A, Pogorzalek, N, Gendron, G, M'Garrech, M, Kaswin, G, Labetoulle, M
• Format: Journal Article
• Language: French
• Published: France 01.03.2012
• Subjects: Administration, Ophthalmic; Aged, 80 and over; Anti-Ulcer Agents - administration & dosage; Anti-Ulcer Agents - therapeutic use; Corneal Ulcer - drug therapy; Corneal Ulcer - etiology; Glycosaminoglycans - administration & dosage; Herpes Zoster - complications; Herpes Zoster - drug therapy; Herpes Zoster Ophthalmicus - complications; Herpes Zoster Ophthalmicus - drug therapy; Humans; Male; Ophthalmic Solutions - administration & dosage; Optic Nerve Diseases - drug therapy; Optic Nerve Diseases - etiology; Regeneration - drug effects; Regeneration - physiology
• ISSN: 1773-0597
• DOI: 10.1016/j.jfo.2011.09.002

Neurotrophic keratopathy is a potential consequence of herpes simplex virus (HSV) or varicella zoster virus (VZV) infection. The treatment is based on artificial tears and the withdrawal of preserved eye drops or other types of epitheliotoxic topical medicines. Autologous serum or amniotic membrane transplantation may also be used in severe cases, but their cost and safety are still under debate. We report a case of a patient with a history of herpes zoster ophthalmicus, who developed a persistent epithelial ulcer after cataract surgery, with no improvement despite 3 weeks of artificial tears (eight drops per day). A new ophthalmologic solution based on a regenerating agent (RGTA, Cacicol20(®)) was then used, with a dosage of two eye drops per week for 6 weeks. Improvement was observed 1 week later, and complete healing was obtained in less than 3 weeks, with no side effects. This heparin mimetic, which may stimulate extracellular matrix healing, may be a possible alternative therapy to autologous serum or amniotic membrane transplantation in severe neurotrophic ulcer. However, randomized studies are necessary to validate this observation.