June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Corneal nerve changes on confocal microscopy after cenegermin treatment for neurotrophic keratitis
Author Affiliations & Notes
  • Changyow Kwan
    Ophthalmology, University of California Irvine, Irvine, California, United States
  • Cinthia Kim
    Ophthalmology, University of California Irvine, Irvine, California, United States
  • Yue Shi
    Ophthalmology, University of California Irvine, Irvine, California, United States
  • Sumit Garg
    Ophthalmology, University of California Irvine, Irvine, California, United States
  • Olivia L Lee
    Ophthalmology, University of California Irvine, Irvine, California, United States
  • Footnotes
    Commercial Relationships   Changyow Kwan None; Cinthia Kim None; Yue Shi None; Sumit Garg Dompe, Code C (Consultant/Contractor); Olivia Lee Cloudbreak Therapeutics, Code C (Consultant/Contractor)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1199 – A0199. doi:
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    • Get Citation

      Changyow Kwan, Cinthia Kim, Yue Shi, Sumit Garg, Olivia L Lee; Corneal nerve changes on confocal microscopy after cenegermin treatment for neurotrophic keratitis. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1199 – A0199.

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

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Abstract

Purpose : Cenegermin, a recombinant human nerve growth factor (rhNGF) eye drop formulation, was recently approved by the U.S. Food and Drug Administration for the treatment neurotrophic keratopathy (NK), a degenerative condition of the cornea characterized by decreased corneal sensation and poor corneal healing. This study aims to better understand the effects of cenegermin on patients with NK by analyzing corneal sensation, epithelial healing and corneal nerve structure through in vivo confocal microscopy (IVCM) before and after treatment.

Methods : This study included five eyes from five patients with NK stage 1 or 2 who completed a 6-week course of cenergemin treatment. Patients underwent clinical examination with assessment of corneal fluorescein staining, corneal sensation using a cotton wisp and examination of IVCM images of the corneal nerves in the basal epithelium neural plexus at baseline and after completing a 6-week course of treatment. The percentage area of corneal epithelial defect on fluorescein images was measured with ImageJ. IVCM images were analyzed for neuron density using NeuronJ (NIH, Bethesda, MD).

Results : Zero out of five eyes had visible corneal nerves on ICVM imaging prior to cenergemin treatment. After treatment, three out of five eyes had visible nerves on ICVM imaging (average density 2284.75 um/mm2). The two patients who did not have visible nerves after treatment had comorbidities including corneal transplant and acanthamoeba infection. Epithelial fluorescein staining improved in all patients. The two eyes with stage 2 NK had epithelial defects at baseline examination, and both had complete resolution after treatment. Corneal sensation was stable in two out of five eyes and improved in three out of five eyes after treatment.

Conclusions : Treatment with cenegermin is effective in promoting corneal epithelial healing and nerve regrowth in patients with NK. Patients had improved epithelial appearance, corneal sensation and nerve density on IVCM after treatment with cenegermin. IVCM is a safe and minimally invasive imaging method that can be used to track structural response to cenegermin treatment.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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