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2026 OMIG Abstract
POSTER PRESENTATION
Topical 1% 5-Fluorouracil as an Effective Treatment for Lisch Epithelial Corneal Dystrophy
Davina A. Malek, Pragat-Jay Muthu, Zishuai Chou, and Carol L. Karp
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
Purpose: To report a case of Lisch Epithelial Corneal Dystrophy (LECD) in a 27-year-old man treated with topical 1% 5-fluorouracil (5-FU).
Methods: Retrospective chart review.
Results: A 27-year-old man with LECD of the left eye (OS) was referred to clinic for evaluation. He had first noticed visual changes approximately five years earlier and was diagnosed with LECD OS about three years before presentation. He subsequently trialed scleral lenses for roughly one year but discontinued them due to poor tolerance and inconsistent vision. On initial examination, best corrected visual acuity (BCVA) OS was 20/100. Slit-lamp evaluation revealed a whirling central corneal epithelial opacity extending toward the 11 o'clock limbus. Anterior segment optical coherence tomography (AS-OCT) demonstrated a centrally hyperreflective epithelium of normal thickness, with trapezoidal edges consistent with classic LECD. He declined any surgical intervention. He was thus started on topical 1% 5-FU 4 times daily, administered in cycles of one week on and three weeks off. After two cycles, his BCVA OS improved to 20/30-2 and his slit-lamp evaluation revealed a notably reduced lesion. Two additional cycles of 5-FU were subsequently administered, and the patient returned three months later. At that visit, BCVA OS was 20/20 -1, and slit-lamp examination showed only a very small residual peripheral corneal opacity at the 10 o'clock position, with a normal-appearing epithelium on AS-OCT. The patient is scheduled to continue for two additional cycles of 5-FU, with follow-up in three months.
Conclusions: Topical 1% 5-FU led to marked improvement in this patient with LECD. The lesion size decreased with each cycle. Further reports would help clarify the optimal treatment regimen and confirm the durability and reproducibility of response.
Disclosure: N (DAM, PJM, ZCN)
S (CLK, NIH Center Core Grant P30EY014801; Research to Prevent Blindness [RPB] Unrestricted Award and Career Development Awards; Dr. Ronald and Alicia Lepke Grant; The Lee and Claire Hager Grant; The Grant and Diana Stanton-Thornbrough Grant; The Robert Baer Family Grant; The Emilyn Page and Mark Feldberg Grant; The Robert Farr Family Grant; The Jose Ferreira de Melo Grant; Mr. and Mrs. Irwin Friedman Grant; The Roberto and Antonia Menendez Family Grant; The Calvin and Flavia Oak Foundation; The Dr. Tim and Cammy Ioannides Grant; The Stephen Takach Grant; The Richard and Kathy Lesser Grant; The Ragheb Family Grant; The Honorable A. Jay Cristol Grant; The Michele and Ted Kaplan Grant; The Zvi Levin Grant; The Carol Soffer Grant; and the Richard Azar Family Grant [institutional grants]
P (CLK, University of Miami - PCT/US2022/029842, 18/562,100, 63/627,578, 63/435,503)
C (CLK, Glaukos, medical advisory board)
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