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Title	Persistent epithelial defects (PED) and neurotrophic ulcer treated with a new topical regenerating agent (RGTA, Cacicol®) associated with topical dexamethasone: a case report
Abstract Nr.	1062

Purpose	Successful use of RGTA+dexamethasone in a patient with PED and neurotrophic ulcer
Methods	A case report
Results	A healthy 61 years old man presented in 10/2012 with a corneal lesion RE since 01/2011 without improvement with topical ganciclovir+prednisolone and transepithelial photherapeutic keratectomy in 10/2011. He presented to our clinic in 03/2012 with a VA of 0,2 RE, a large epithelial punctate keratitis (EPK) with underlying anterior stromal opacification and a decreased corneal sensitivity of unknown etiology. The lesions did not respond to autologous serum 20% or 50%. A treatment with a new topical RGTA 1/w was applied in 05/2012 followed by a worsening of stromal opacities at 3 weeks. Treatment was consequently stopped. Topical preservative-free dexamethasone and preservative-free artificial tear were then administered 2/week. A symptomatic stabilization of the lesions was obtained with a stabilization of VA to 0.2 in 01/ 2013 and topical dexamethasone was then stopped. In 05/2013, RGTA therapy was reintroduced 2/w and an improvement of the EPK but stable stromal opacity was observed in 08/2013. In 03/2014 he presented a neurotrophic ulcer (4x1mm) and a new adjacent lesion. Topical RGTA+dexamethasone was then administered 2 /w and 2 weeks later, the corneal ulcer and most of the stromal opacification healed with a VA improved to 1.0. This impressive corneal improvement persisted for the following 3 months.
Conclusion	RGTA+dexamethasone (2/w) might be useful for the healing of PED and neurotrophic ulcers and need further investigation

Authors 1

Last name	CABAY
Initials	LC
Department	CHU St-Pierre
City	Bruxelles

Authors 2

Last name	Elmaleh V
Initials	VE
Department	CHU St-Pierre
City	Bruxelles

Authors 3

Last name	Willermain F
Initials	FW
Department	CHU St-Pierre
City	Bruxelles

Authors 4

Last name	Caspers L
Initials	LC
Department	CHU St-Pierre
City	Bruxelles