Abstract
Purpose :
Topical recombinant human nerve growth factor (rhNGF) is FDA-approved to treat patients with neurotrophic keratitis (NK), but current clinical trial data only encompasses 1 year of follow up. We hypothesize that a single course of rhNGF can have a long-term, persistent effect on NK healing and related clinical parameters. Therefore, we evaluated the long-term efficacy of rhNGF in a retrospective, consecutive, observational case series from a single-center setting over a 4-year period.
Methods :
A total of 18 patients with stage 2 or 3 NK received rhNGF 20 mcg/ml 6 times a day for 8 weeks. Lesion recurrence during follow-up was evaluated at 12, 24, 36, and 48 months. Clinical efficacy was measured by Cochet-Bonnet aesthesiometer (corneal sensitivity), Schirmer’s test (tear production), and Snellen chart [visual acuity (VA)] at baseline, end of treatment (8 weeks), and at 12, 24, 36, and 48 months after treatment was completed.
Results :
Four patients experience recurrence during the study; 3 within the first 12 months and 1 within 36 months. Corneal sensitivity was significantly improved by the end of treatment (8 weeks) with improvements persisting throughout 48 months of follow-up (P<0.05). Both tear production and VA were also significantly improved by the end of treatment (8 weeks) and these effects persisted at 12, 24, and 36 months (P<0.05). Improvements in tear production and VA were also seen at 48 months; however, they were not statistically significant.
Conclusions :
These results are consistent with our hypothesis that a single, 8-week treatment regimen of rhNGF can have long lasting clinical effects. The long-term clinical utility of rhNGF for the treatment of NK was demonstrated though the low rate of lesion recurrence along with improvements in corneal sensitivity, tear production, and VA over the course of 4 years.
This is a 2021 ARVO Annual Meeting abstract.