Evidence map›Paper›PMID 41778091›Full record

ArticleAmerican journal of ophthalmology case reports2026

Topical losartan to prevent stromal scarring during post-cross-linking infection in pediatric keratoconus: A case report.

Francesca Barzaghi, Martin Kronschläger, Sahand Amir-Asgari, Oliver Findl

Abstract readCase Reports
In one paragraph

Article in American journal of ophthalmology case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Francesca BarzaghiVienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, 1140, Austria.
Martin KronschlägerVienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, 1140, Austria.
Sahand Amir-AsgariVienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, 1140, Austria.
Oliver FindlVienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, 1140, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: To report a pediatric case of post-corneal cross-linking (CXL) infectious keratitis successfully managed with early initiation of topical losartan to prevent corneal haze and stromal fibrosis. Case report: A 14-year-old boy developed infectious keratitis in the right eye two days after undergoing bilateral epithelium-off CXL for advanced keratoconus. Slit-lamp examination revealed a mid-peripheral ring-shaped stromal infiltrate with overlying epithelial defect, edema, and posterior fibrin. Intensive empirical antimicrobial therapy was initiated. Off-label topical losartan 0.08% was started at twice a day on day 4 post-CXL to mitigate fibrotic remodeling. The infection resolved without complications, and 0.08% topical losartan was progressively increased to four times a day for a total duration of three months. Stromal clarity improved significantly over the following weeks, with no adverse effects or recurrence in the following three months after cessation of the losartan. Conclusions and importance: This case demonstrates that early topical losartan can be safely administered in the acute phase of post-infectious keratitis in a pediatric patient. Although early use appeared to limit scar formation, the presence of a residual central corneal scar and reduced visual acuity precludes any conclusions regarding its effectiveness in improving visual outcomes. These findings suggest that timely antifibrotic therapy may influence corneal healing, but controlled studies are needed to define its efficacy, optimal timing, and dosing in both pediatric and adult populations.

Identifiers

PMID41778091
PMCPMC12952774

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