Diagnosis and management of neurotrophic keratitis

Marta Sacchetti,1 Alessandro Lambiase2 1Cornea and Ocular Surface Unit, Ospedale San Raffaele di Milano-IRCCS, Milan, 2Ophthalmology, University La Sapienza of Rome, Italy Abstract: Neurotrophic keratitis (NK) is a degenerative disease characterized by corneal sensitivity reduction, spontaneous ep...

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Autores principales:	Sacchetti M, Lambiase A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/42d66132d291480cb6f72b361b11e5d6
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spelling	oai:doaj.org-article:42d66132d291480cb6f72b361b11e5d62021-12-02T05:52:08ZDiagnosis and management of neurotrophic keratitis1177-5483https://doaj.org/article/42d66132d291480cb6f72b361b11e5d62014-03-01T00:00:00Zhttp://www.dovepress.com/diagnosis-and-management-of-neurotrophic-keratitis-a16151https://doaj.org/toc/1177-5483 Marta Sacchetti,1 Alessandro Lambiase2 1Cornea and Ocular Surface Unit, Ospedale San Raffaele di Milano-IRCCS, Milan, 2Ophthalmology, University La Sapienza of Rome, Italy Abstract: Neurotrophic keratitis (NK) is a degenerative disease characterized by corneal sensitivity reduction, spontaneous epithelium breakdown, and impairment of corneal healing. Several causes of NK, including herpetic keratitis, diabetes, and ophthalmic and neurosurgical procedures, share the common mechanism of trigeminal damage. Diagnosis of NK requires accurate investigation of clinical ocular and systemic history, complete eye examination, and assessment of corneal sensitivity. All diagnostic procedures to achieve correct diagnosis and classification of NK, including additional examinations such as in vivo confocal microscopy, are reviewed. NK can be classified according to severity of corneal damage, ie, epithelial alterations (stage 1), persistent epithelial defect (stage 2), and corneal ulcer (stage 3). Management of NK should be based on clinical severity, and aimed at promoting corneal healing and preventing progression of the disease to stromal melting and perforation. Concomitant ocular diseases, such as exposure keratitis, dry eye, and limbal stem cell deficiency, negatively influence the outcome of NK and should be treated. Currently, no specific medical treatment exists, and surgical approaches, such as amniotic membrane transplantation and conjunctival flap, are effective in preserving eye integrity, without ameliorating corneal sensitivity or visual function. This review describes experimental and clinical reports showing several novel and potential therapies for NK, including growth factors and metalloprotease inhibitors, as well as three ongoing Phase II clinical trials. Keywords: neurotrophic keratitis, cornea sensitivity, cornea innervation, persistent epithelial defectSacchetti MLambiase ADove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2014, Iss default, Pp 571-579 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Sacchetti M Lambiase A Diagnosis and management of neurotrophic keratitis
description	Marta Sacchetti,1 Alessandro Lambiase2 1Cornea and Ocular Surface Unit, Ospedale San Raffaele di Milano-IRCCS, Milan, 2Ophthalmology, University La Sapienza of Rome, Italy Abstract: Neurotrophic keratitis (NK) is a degenerative disease characterized by corneal sensitivity reduction, spontaneous epithelium breakdown, and impairment of corneal healing. Several causes of NK, including herpetic keratitis, diabetes, and ophthalmic and neurosurgical procedures, share the common mechanism of trigeminal damage. Diagnosis of NK requires accurate investigation of clinical ocular and systemic history, complete eye examination, and assessment of corneal sensitivity. All diagnostic procedures to achieve correct diagnosis and classification of NK, including additional examinations such as in vivo confocal microscopy, are reviewed. NK can be classified according to severity of corneal damage, ie, epithelial alterations (stage 1), persistent epithelial defect (stage 2), and corneal ulcer (stage 3). Management of NK should be based on clinical severity, and aimed at promoting corneal healing and preventing progression of the disease to stromal melting and perforation. Concomitant ocular diseases, such as exposure keratitis, dry eye, and limbal stem cell deficiency, negatively influence the outcome of NK and should be treated. Currently, no specific medical treatment exists, and surgical approaches, such as amniotic membrane transplantation and conjunctival flap, are effective in preserving eye integrity, without ameliorating corneal sensitivity or visual function. This review describes experimental and clinical reports showing several novel and potential therapies for NK, including growth factors and metalloprotease inhibitors, as well as three ongoing Phase II clinical trials. Keywords: neurotrophic keratitis, cornea sensitivity, cornea innervation, persistent epithelial defect
format	article
author	Sacchetti M Lambiase A
author_facet	Sacchetti M Lambiase A
author_sort	Sacchetti M
title	Diagnosis and management of neurotrophic keratitis
title_short	Diagnosis and management of neurotrophic keratitis
title_full	Diagnosis and management of neurotrophic keratitis
title_fullStr	Diagnosis and management of neurotrophic keratitis
title_full_unstemmed	Diagnosis and management of neurotrophic keratitis
title_sort	diagnosis and management of neurotrophic keratitis
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/42d66132d291480cb6f72b361b11e5d6
work_keys_str_mv	AT sacchettim diagnosisandmanagementofneurotrophickeratitis AT lambiasea diagnosisandmanagementofneurotrophickeratitis
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Diagnosis and management of neurotrophic keratitis

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