Abstract
Purpose :
Infectious bacterial keratitis and infectious crystalline keratopathy (ICK) are both serious and visually threatening ocular infections. We hypothesise corneal nerves, and their derivatives, are important in the pathogenesis of both bacterial keratitis and ICK. We performed a systematic review into the role of corneal nerves during infectious bacterial keratitis and ICK to highlight areas of interest, or possible future research, for the development of new and improved treatment regimens for infectious bacterial keratitis and ICK.
Methods :
A systematic literature search of the PubMed database was performed, identifying 64 articles relating to the role of corneal nerves in bacterial keratitis or ICK. Articles were screened and selected, leaving a total of 23 papers included for review.
Results :
The results of our study detail the alterations of nerve structure during infection, demonstrate the influence of corneal nerves on bacterial keratitis, and suggest the consequences of the lack of nerves in ICK. Neurochemistry was shown to have a distinctive influence on inflammation, chemotaxis of inflammatory cells, and resolution of infection. In addition to this, MicroRNA and tear cytokines were associated with corneal nerves, their structural changes, and disease response. Corneal nerves and their neurochemistry also altered the corneal healing response during infection.
Conclusions :
Corneal nerves are imperative in the immune response towards infectious bacterial keratitis. Corneal nerves influence and coordinate a spectrum of host responses to infection, including cytokine production, immunomodulation, and corneal healing. Therapeutic agents targeting corneal nerves and ocular neurochemistry should be studied and considered as possible treatments for the infection and recovery of infectious bacterial keratitis. More research into physiological mechanisms is also needed to improve our understanding of corneal nerves during infection.
This is a 2021 ARVO Annual Meeting abstract.