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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...

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Autores principales: NaPier, Erin, Camacho, Matthew, McDevitt, Timothy F., Sweeney, Adam R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2022
Materias:
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.
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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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