July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Corneal ultrastructural modifications after therapy with Cenegermin eye drops for the treatment of moderate-severe neurotrophic keratopathy
Author Affiliations & Notes
  • Luca Napoli
    Ophthalmology Clinic, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, University of Brescia, Brescia, Italy, Sorisole, Italy
  • Eliana Forbice
    Ophthalmology Clinic, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, University of Brescia, Brescia, Italy, Sorisole, Italy
  • Francesco Semeraro
    Ophthalmology Clinic, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, University of Brescia, Brescia, Italy, Sorisole, Italy
  • Footnotes
    Commercial Relationships   Luca Napoli, None; Eliana Forbice, None; Francesco Semeraro, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3244. doi:https://doi.org/
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      Luca Napoli, Eliana Forbice, Francesco Semeraro; Corneal ultrastructural modifications after therapy with Cenegermin eye drops for the treatment of moderate-severe neurotrophic keratopathy. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3244. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate efficacy, clinical changes and corneal ultrastructural modifications after therapy with Cenegermin (recombinant human nerve growth factor) eye drops for the treatment of moderate-severe neurotrophic keratopathy (NK) by in vivo corneal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT)

Methods : A retrospective case analysis was performed on 6 patients with NK treated with Cenegermin eye drops 6 times a day for 4 weeks. Clinical parameters evaluated were: ocular surface disease index (OSDI), best corrected visual acuity (BVCA), break-up time (BUT), Schirmer Test, corneal epithelial defect area and esthesiometry. Density of desquamation cells, methaplasy, basal epithelial cells, corneal nerves, activated keratocytes, Langerhans cells and grade of fibrosis and nerve fibers tortuosity were evaluated by IVCM using computer software NeuroJ. Variations of the mean of each parameter in the population over time were calculated with the Linear Mixed Model test

Results : Statistically significant (p<0.05) variations were: decrease in density of desquamation cells (from 388 to 202 cell/mm2)and increment of basal epithelial cells (from 3733 to 5310 cell/mm2); BUT and esthesiometry improvement (respectively from 4.1 to 7.6 mm and from 1.5 to 3.6 cm); area of the lesion reduction from 4.49 to 0.07 mm2. In five out of six patients there was a complete reepithelization of the cornea after 4 weeks of treatment. No adverse effects were reported. A not significant global improvement in subepithelial corneal nerve plexus and a reduction of corneal metaplastic cells were noticed

Conclusions : Cenegermin eye drops seems to be an effective and safe therapy for moderate-severe NK not responsive to other medical treatments. It aims to re-establish corneal integrity by restoring corneal nerves and sensibility. Further studies are necessary to better understand corneal re-innervation process specially in patients with severe corneal ultrastructural alterations

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

 

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