{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T21:24:30Z","timestamp":1794605070105,"version":"4.9.1"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ophthalmol Eye Dis"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>\n                    This study evaluated the effectiveness of topical losartan 1\u2009mg\/mL in reducing corneal fibrosis by inhibiting myofibroblast proliferation and improving corneal transparency, offering a potential therapeutic alternative. A prospective, interventional case series enrolled adults with corneal fibrosis. Participants administered topical losartan 1\u2009mg\/mL six times daily for 3\u2009months. Visual acuity, slit-lamp examination, corneal tomography, and densitometry were used to assess outcomes. A Random Forest machine learning model identified key predictors of visual improvement. Nineteen eyes from seventeen patients were analyzed. Mean uncorrected distance visual acuity improved from 1.04\u2009\u00b1\u20090.62 to 0.74\u2009\u00b1\u20090.46 LogMAR (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.007). Corneal densitometry significantly decreased, particularly in the midperipheral zone (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.0184). Worse baseline visual acuity and longer leukoma duration correlated with greater improvement. The predictive model achieved an AUROC of 0.76, with 86.67% sensitivity, 75.00% specificity, and 84.21% accuracy, confirming its robustness. These findings suggest that topical losartan improves corneal transparency and functional vision in patients with corneal fibrosis. The predictive model provides a clinically useful scoring system to guide treatment selection. Further validation in larger clinical trials is warranted.\n                  <\/jats:p>","DOI":"10.1177\/25158414251378123","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T11:43:06Z","timestamp":1763120586000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Topical losartan for established corneal fibrosis with machine learning-based predictors"],"prefix":"10.1177","volume":"17","author":[{"given":"Jorge Luis","family":"Domene-Hickman","sequence":"first","affiliation":[{"name":"Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4272-6497","authenticated-orcid":false,"given":"Luis","family":"Haro-Morlett","sequence":"additional","affiliation":[{"name":"Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Lichtinger","sequence":"additional","affiliation":[{"name":"Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7125-5746","authenticated-orcid":false,"given":"Angelica","family":"Hernandez-Solis","sequence":"additional","affiliation":[{"name":"Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Ramirez Miranda","sequence":"additional","affiliation":[{"name":"Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Navas","sequence":"additional","affiliation":[{"name":"Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique O.","family":"Graue-Hernandez","sequence":"additional","affiliation":[{"name":"Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Chimalpopoca 14, Obrera, Cuauhtemoc, Mexico City 06800, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2023.03.012"},{"issue":"3","key":"e_1_3_4_3_2","first-page":"214","article-title":"Corneal blindness: a global perspective","volume":"79","author":"Whitcher JP","year":"2001","unstructured":"Whitcher JP, Srinivasan M, Upadhyay MP. Corneal blindness: a global perspective. Bull World Health Organ 2001; 79(3): 214\u2013221.","journal-title":"Bull World Health Organ"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1006\/exer.2002.2066"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.exer.2020.108325"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2015.4776"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2024.07.005"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.6.789"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.exer.2022.108940"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1167\/tvst.12.9.20"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1167\/TVST.13.8.22"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1167\/tvst.11.7.9"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20221026-03"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20221018-02"},{"key":"e_1_3_4_15_2","doi-asserted-by":"crossref","unstructured":"Burgos-Blasco B Moloney G. Topical losartan for corneal fibrosis: a case series with densitometry analysis www.corneajrnl.com (2024).","DOI":"10.1097\/ICO.0000000000003783"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1089\/jop.2022.0174"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.exer.2024.109884"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2023.4638"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2020.02.021"},{"issue":"5","key":"e_1_3_4_20_2","first-page":"803","article-title":"Role of corneal collagen fibrils in corneal disorders and related pathological conditions","volume":"10","author":"Zhou HY","year":"2017","unstructured":"Zhou HY, Cao Y, Wu J, et al. Role of corneal collagen fibrils in corneal disorders and related pathological conditions. Int J Ophthalmol 2017; 10(5): 803\u2013811.","journal-title":"Int J Ophthalmol"},{"issue":"9","key":"e_1_3_4_21_2","first-page":"1959","article-title":"Transforming growth factor(beta)-mediated corneal myofibroblast differentiation requires actin and fibronectin assembly","volume":"40","author":"Jester JV","year":"1999","unstructured":"Jester JV, Huang J, Barry-Lane PA, et al. Transforming growth factor(beta)-mediated corneal myofibroblast differentiation requires actin and fibronectin assembly. Invest Ophthalmol Vis Sci 1999; 40(9): 1959\u20131967.","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-19413-z"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.2196\/21798"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-022-01504-4"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v28.i5.605"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2016.034"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-024-02198-2"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/4932856"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.jcrs.0000000000001353"}],"container-title":["Therapeutic Advances in Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/25158414251378123","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/25158414251378123","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/25158414251378123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:40:54Z","timestamp":1777596054000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/25158414251378123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":28,"alternative-id":["10.1177\/25158414251378123"],"URL":"https:\/\/doi.org\/10.1177\/25158414251378123","relation":{},"ISSN":["2515-8414","2515-8414"],"issn-type":[{"value":"2515-8414","type":"print"},{"value":"2515-8414","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"article-number":"25158414251378123"}}