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Neurotrophic keratopathy: current challenges and future prospects
Neurotrophic keratopathy (NK), or neurotrophic keratitis, is a degenerative condition that results from decreased innervation to the cornea. The cornea is innervated by the ophthalmic branch of the trigeminal nerve. Neurotrophic keratopathy is most commonly caused by herpes keratitis however, any co...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8903790/ https://www.ncbi.nlm.nih.gov/pubmed/35243932 http://dx.doi.org/10.1080/07853890.2022.2045035 |
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author | NaPier, Erin Camacho, Matthew McDevitt, Timothy F. Sweeney, Adam R. |
author_facet | NaPier, Erin Camacho, Matthew McDevitt, Timothy F. Sweeney, Adam R. |
author_sort | NaPier, Erin |
collection | PubMed |
description | Neurotrophic keratopathy (NK), or neurotrophic keratitis, is a degenerative condition that results from decreased innervation to the cornea. The cornea is innervated by the ophthalmic branch of the trigeminal nerve. Neurotrophic keratopathy is most commonly caused by herpes keratitis however, any condition that disrupts the normal corneal innervation can cause NK. Neurotrophic keratopathy is a clinical diagnosis and is classified into three stages based on the disease severity. Stage 1 has mild epithelial defects, such as punctate keratopathy, stage 2 disease has persistent epithelial defects, and stage 3 is defined by the presence of ulcers. Current treatment modalities consist of medical and surgical options. Stage 1 is treated with lubrication through artificial tears, eyelid taping, and punctal plug/cautery. Stage 2 treatment can involve therapeutic contact lenses, topical autologous or allogenic serum, tarsorrhaphy, botulinum toxin injections, and possibly anti-inflammatory medications. Stage 3 disease may require human nerve growth factor, amniotic membrane transplantation, conjunctival flap, or corneal neurotization. New therapies, such as matrix regenerating therapy, plasma rich in growth factors, Thymosin β4, Substance P/Insulin like growth factor-1, and nicergoline represent exciting future options. KEY MESSAGES: Neurotrophic keratopathy is a rare degenerative disease defined by decreased innervation to the cornea that is associated with significant morbidity. Treatment options range from lubrication alone to various medical and surgical treatments. Matrix regenerating therapy, plasma rich in growth factors, Thymosin β4, Substance P/Insulin like growth factor-1, and nicergoline are exciting novel therapies that will influence how neurotrophic keratopathy is treated in the future. |
format | Online Article Text |
id | pubmed-8903790 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-89037902022-03-09 Neurotrophic keratopathy: current challenges and future prospects NaPier, Erin Camacho, Matthew McDevitt, Timothy F. Sweeney, Adam R. Ann Med Ophthalmology Neurotrophic keratopathy (NK), or neurotrophic keratitis, is a degenerative condition that results from decreased innervation to the cornea. The cornea is innervated by the ophthalmic branch of the trigeminal nerve. Neurotrophic keratopathy is most commonly caused by herpes keratitis however, any condition that disrupts the normal corneal innervation can cause NK. Neurotrophic keratopathy is a clinical diagnosis and is classified into three stages based on the disease severity. Stage 1 has mild epithelial defects, such as punctate keratopathy, stage 2 disease has persistent epithelial defects, and stage 3 is defined by the presence of ulcers. Current treatment modalities consist of medical and surgical options. Stage 1 is treated with lubrication through artificial tears, eyelid taping, and punctal plug/cautery. Stage 2 treatment can involve therapeutic contact lenses, topical autologous or allogenic serum, tarsorrhaphy, botulinum toxin injections, and possibly anti-inflammatory medications. Stage 3 disease may require human nerve growth factor, amniotic membrane transplantation, conjunctival flap, or corneal neurotization. New therapies, such as matrix regenerating therapy, plasma rich in growth factors, Thymosin β4, Substance P/Insulin like growth factor-1, and nicergoline represent exciting future options. KEY MESSAGES: Neurotrophic keratopathy is a rare degenerative disease defined by decreased innervation to the cornea that is associated with significant morbidity. Treatment options range from lubrication alone to various medical and surgical treatments. Matrix regenerating therapy, plasma rich in growth factors, Thymosin β4, Substance P/Insulin like growth factor-1, and nicergoline are exciting novel therapies that will influence how neurotrophic keratopathy is treated in the future. Taylor & Francis 2022-03-04 /pmc/articles/PMC8903790/ /pubmed/35243932 http://dx.doi.org/10.1080/07853890.2022.2045035 Text en © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Ophthalmology NaPier, Erin Camacho, Matthew McDevitt, Timothy F. Sweeney, Adam R. Neurotrophic keratopathy: current challenges and future prospects |
title | Neurotrophic keratopathy: current challenges and future prospects |
title_full | Neurotrophic keratopathy: current challenges and future prospects |
title_fullStr | Neurotrophic keratopathy: current challenges and future prospects |
title_full_unstemmed | Neurotrophic keratopathy: current challenges and future prospects |
title_short | Neurotrophic keratopathy: current challenges and future prospects |
title_sort | neurotrophic keratopathy: current challenges and future prospects |
topic | Ophthalmology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8903790/ https://www.ncbi.nlm.nih.gov/pubmed/35243932 http://dx.doi.org/10.1080/07853890.2022.2045035 |
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