Pirfenidone: A Promising Drug in Ocular Therapeutics

Abstract

Pirfenidone, initially indicated for lung fibrosis, has gone beyond its original purpose, and shown promise in eye care. This detailed review tracks its evolution from lung treatment to aiding eye healing as evidenced by published literature. Pirfenidone's multifaceted attributes extend to mitigating corneal fibrosis, inflammation, and trauma. Through rigorous investigations, its efficacy emerges in diabetic retinopathy, macular degeneration, and postoperative glaucoma interventions. As an unheralded protagonist, pirfenidone reshapes ocular care paradigms, inviting renewed research opportunities.

Etiopathology, Epidemiology, Diagnosis, and Treatment of Fungal Keratitis

“…However, their prolonged use may increase the risk of fungal comorbidities, which can potentially be life-threatening. The published reports also suggests the therapeutic potential of pirfenidone as potential corneal wound healing agent with inflammatory properties. ,,− …”

“…It is sometimes referred to as corneal fibrosis or late haze. 37 The antifibrotic drugs like nintedanib, 38 5-fluorouracil, 39 pirfenidone, 34,35 mitomycin, 40,41 celastrol, 42 and losartan 43,44 are reported to have antifibrotic potential and studied for managing corneal scarring. Reportedly, topical losartan (angiotensin receptor II blocker) inhibits corneal scarring fibrosis, collagen type IV deposition 45 and used after refractive surgery in corneal infection case to treat corneal fibrosis.…”

“…Currently, in clinical settings, pharmacotherapy for fungal keratitis includes effective antifungal agents combined with anti-inflammatory medications. , These includes the use of topical natamycin, amphotericin B, fluconazole, voriconazole aided with dexamethasone, diclofenac, and ketorolac like NSAIDs. − In a prospective clinical study, voriconazole was identified as an effective and well-tolerated drug for the management of stubborn corneal ulcers resulting from Aspergillus keratitis . However, severe inflammatory FK often associated with corneal wounds which progresses to ulcers and eventually leaves corneal scar which leads to vision impairment. ,, Corneal scarring stands as a primary contributor to the loss of corneal transparency and resultant blindness on a global scale . Corneal scarring is a reaction to damage, infection, surgery, or systemic illness that disturbs tissue homeostasis.…”

“…It is sometimes referred to as corneal fibrosis or late haze . The antifibrotic drugs like nintedanib, 5-fluorouracil, pirfenidone, , mitomycin, , celastrol, and losartan , are reported to have antifibrotic potential and studied for managing corneal scarring. Reportedly, topical losartan (angiotensin receptor II blocker) inhibits corneal scarring fibrosis, collagen type IV deposition and used after refractive surgery in corneal infection case to treat corneal fibrosis. , Losartan, when used as a supplementary treatment alongside current therapies, holds promise in enhancing pharmacological interventions for various ocular diseases and disorders, particularly those characterized by fibrotic pathophysiology where transforming growth factor beta (TGF-β) plays a pivotal role .…”

“…33 However, severe inflammatory FK often associated with corneal wounds which progresses to ulcers and eventually leaves corneal scar which leads to vision impairment. 24,34,35 Corneal scarring stands as a primary contributor to the loss of corneal transparency and resultant blindness on a global scale. 36 Corneal scarring is a reaction to damage, infection, surgery, or systemic illness that disturbs tissue homeostasis.…”