Losartán Tópico Como Tratamiento En Defectos Epiteliales Corneales: Una Revisión Sistemática De La Literatura

Abstract

Objective: To bibliographically characterize and analyze the therapeutic effects and safety of topical losartan in the cornea, based on evidence published in the last ten years. Methodology: Systematic literature review in indexed databases Embase, ProQuest, Scielo, ClinicalKey, PubMed, and Scielo, using MeSH and DeCS descriptors in Spanish and English, in combination with Boolean operators, including studies from 2015 to 2025, with in vivo experimental design method, human clinical reports, or case series, in full text in Spanish or English. Articles with in vitro method, without methodological data, duplicates, or older than 10 years were excluded. Finally, 7 articles were included. Results: The included studies were published between 2022 and 2025, all in English. Three of these were developed with experimental models in rabbits and four with clinical studies in humans. The most commonly used concentration was 0.8 mg/ml with a frequency of 6 times a day, following progressive reduction schemes in prolonged treatments. In animal models, losartan managed to decrease the generation of myofibroblasts, attenuating corneal fibrosis, having greater efficacy in early or less complex lesions. In established fibrosis, it showed apoptosis of myofibroblasts and a tendency to stromal clearing, having modest haze reduction in the short term. In human clinical cases, patients experienced improvement in corneal transparency and visual acuity even when steroid treatment had failed. There were no reports of adverse events. Conclusions: Topical losartan is a possible alternative to the treatments of corneal fibrosis and scarring, showing efficacy in studies in animals and humans.