Neurotrophic keratitis

Abstract

Neurotrophic keratopathy is a degenerative corneal disease induced by an impairment of trigeminal nerve. Impairment of loss of corneal sensory innervation is responsible for corneal epithelial defects, ulcer, and perforation. In the present report, we reviewed the pathogenesis, diagnosis, and therapeutic aspects of this disease. An accurate history and clinical examination, including the function of cranial nerves, together with the clinical features of the ocular surface are essential for a prompt diagnosis. The evaluation of the corneal sensitivity and tear film function are important diagnostic steps as well. Specific medical and surgical treatments, based on the clinical staging of the disease, are often able to halt its progression. Future developments in the medical treatment including the administration of neuropeptide and growth factors are presented.

IL-6 Contributes to Corneal Nerve Degeneration after Herpes Simplex Virus Type I Infection

“…Neurotrophic keratitis (NTK) is a degenerative disease caused by impairment of the trigeminal corneal innervation, leading to corneal epithelial breakdown, impairment of healing, and development of ulceration, melting, and perforation. 3 The hallmark of NTK is decreased or absent corneal sensation, common to all stages of its diagnosis. 3,4 Examples of noninfectious causes of NTK include trigeminal nerve damage associated with orbital and head injury, head trauma, aneurysms, or intracranial neurological disease, laser in situ keratomieulieusis procedures, and diabetes mellitus.…”

“…3 The hallmark of NTK is decreased or absent corneal sensation, common to all stages of its diagnosis. 3,4 Examples of noninfectious causes of NTK include trigeminal nerve damage associated with orbital and head injury, head trauma, aneurysms, or intracranial neurological disease, laser in situ keratomieulieusis procedures, and diabetes mellitus. 5e8 Herpetic viral infections of the cornea, such as herpes simplex virus type 1 (HSV-1), are thought to be a major cause for the development of NTK.…”

Herpes Zóster oftálmico en la atención primaria de un caso Clínico en Villa de Leyva

“…También hay que diferenciar la queratitis neurotrófica producida por el herpes zóster de la hipoestesia o total anestesia corneal asociada a tumores (neurinoma, meningioma), de la enfermedad desmielinizante (esclerosis múltiple), del infarto cerebral, los aneurismas y las causas iatrogénicas como la irradiación de la superficie ocular, neurocirugía, cirugía refractiva corneal o ablación del cuerpo ciliar (5,9,14,15).…”

Central Connections of the Lacrimal Functional Unit

“…12 A decrease in sensory nerve function can also be caused by systemic disorders such as diabetes or multiple sclerosis. 13 Bilateral topical anaesthesia has been shown to reduce but not abolish lacrimal secretion in both eyes, measured by the Schirmer I test [14][15][16] or by fluorophotometry 15 and similarly, unilateral trigeminal anaesthesia, as caused by herpes simplex keratitis, is accompanied by an ipsilateral reduction in reflex tear secretion, of a degree dependent on the level of sensory loss on the affected side. 17,18 Additionally, a lesser fall in the reflex tear response occurs in the unaffected eye.…”