Neurotrophic Keratopathy in Pediatric Patients

Scelfo, Christina; Mantagos, Iason S.

doi:10.1080/08820538.2021.1896747

Cited by 11 publications

(12 citation statements)

References 47 publications

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“…Recent advances both in medical and surgical interventions have made corneal reinnervation and restoration of vision more easily attainable in pediatric patients. 12 Among novel medical therapies, contrasting results are reported for pediatric use of topical NGF. On one hand, various case reports showed the successful outcomes of this treatment in pediatric NK owing to different etiologies.…”

Section: Discussionmentioning

confidence: 99%

Maternal serum eye drops to treat bilateral neurotrophic keratopathy in congenital corneal anesthesia: Case report and literature review

Giannaccare

Lucisano

Pellegrini

et al. 2022

American Journal of Ophthalmology Case Reports

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Section: Discussionmentioning

confidence: 99%

Maternal serum eye drops to treat bilateral neurotrophic keratopathy in congenital corneal anesthesia: Case report and literature review

Giannaccare

Lucisano

Pellegrini

et al. 2022

American Journal of Ophthalmology Case Reports

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“…After gaining FDA approval in August 2018, this drug became available in the USA in early 2019. This drug targets nerve pathology and has potential to address the underlying deficit in NK by enhancing corneal nerve growth, restoring corneal sensation, and augmenting corneal healing [130][131][132][133]. Clinical trials in NK patients found Cenegermin eyedrops to be safe and effective in restoring corneal integrity, and a randomized control trial found that these drops have higher rates of corneal healing compared to placebo [134,135].…”

Section: Recombinant Human Nerve Growth Factor: Cenegerminmentioning

confidence: 99%

Treatment of Non-Infectious Corneal Injury: Review of Diagnostic Agents, Therapeutic Medications, and Future Targets

Dang

Riaz

Karamichos

2022

Drugs

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Corneal injuries can occur secondary to traumatic, chemical, inflammatory, metabolic, autoimmune, and iatrogenic causes. Ocular infection may frequently occur concurrent to corneal injury; however, antimicrobial agents are excluded from this present review. While practitioners may primarily rely on clinical examination techniques to assess these injuries, several pharmacological agents, such as fluorescein, lissamine green, and rose bengal, can be used to formulate a diagnosis and develop effective treatment strategies. Practitioners may choose from several analgesic medications to help with patient comfort without risking further injury or delaying ocular healing. Atropine, cyclopentolate, scopolamine, and homatropine are among the most frequently used medications for this purpose. Additional topical analgesic agents may be used judiciously to augment patient comfort to facilitate diagnosis. Steroidal anti-inflammatory agents are frequently used as part of the therapeutic regimen. A variety of commonly used agents, including prednisolone acetate, loteprednol, difluprednate, dexamethasone, fluorometholone, and methylprednisolone are discussed. While these medications are effective for controlling ocular inflammation, side effects, such as elevated intraocular pressure and cataract formation, must be monitored by clinicians. Non-steroidal medications, such as ketorolac, bromfenac, nepafenac, and diclofenac, are additionally used for their efficacy in controlling ocular inflammation without incurring side effects seen with steroids. However, these agents have their own respective side effects, warranting close monitoring by clinicians. Additionally, ophthalmologists routinely employ several agents in an off-label manner for supplementary control of inflammation and treatment of corneal injuries. Patients with corneal injuries not infrequently have significant ocular surface disease, either as a concurrent pathology or as an exacerbation of previously existing disease. Several agents used in the management of ocular surface disease have also been found to be useful as part of the therapeutic armamentarium for treatment of corneal injuries. For example, several antibiotics, such as doxycycline and macrolides, have been used for their anti-inflammatory effects on specific cytokines that are upregulated during acute injuries. There has been a recent wave of interest in amniotic membrane therapies (AMTs), including topical, cryopreserved and dehydrated variants. AMT is particularly effective in ocular injuries with violation of corneal surface integrity due to its ability to promote reepithelialization of the corneal epithelium. Blood-based therapies, including autologous serum tears, plasma-enriched growth factor eyedrops and autologous blood drops, have additionally been explored in small case series for effectiveness in challenging and recalcitrant cases. Protection of the ocular surface is also a vital component in the treatment of corneal injuries. Temporary protective methods, such as bandage contact lenses and me...

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“…Any clinical condition that damages the trigeminal nerve at any point, from the nucleus to the terminal corneal fibres, predisposes patients to developing NK (Table 2). 4,[10][11][12][13] The most common conditions leading to corneal anaesthesia include herpes infections of the cornea and iatrogenic damage from neurosurgical procedures, such as for trigeminal neuralgia or resection of a vestibular schwannoma. 10,11 Ocular conditions leading to NK include: overwearing contact lenses; previous corneal, refractive or retinal surgery; lattice and granular corneal dystrophies; chemical exposure; topical anaesthetic abuse; and long-term use of topical medications, such as non-steroidal anti-inflammatory drugs.…”

Section: Aetiologymentioning

confidence: 99%

“…Moebius syndrome, Goldenhar syndrome, familial dysautonomia and familial corneal hypesthesia. 13 The inciting aetiology may influence the progression and prognosis of NK, depending on the severity of the corneal nerve impairment and the concomitant ocular surface integrity. 10…”

Section: Congenital Conditions That Can Cause Corneal Sensory Deficit...mentioning

confidence: 99%

Neurotrophic Keratitis: A Review

Duncan¹,

Houser²,

Khandelwal³

2022

US Ophthalmic Review

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Impairment in trigeminal nerve function causes a loss of corneal sensation and can lead to neurotrophic keratitis (NK). This gradual deterioration in the surface integrity of the cornea predisposes to the development of ulcers and may even progress to perforation, posing a risk for profound vision loss. Many common ophthalmic and systemic conditions, such as herpetic infections, ocular surgeries, neurosurgical procedures, multiple sclerosis and diabetes, can elicit NK by injuring the trigeminal nerve. Disease progression can occur rapidly and without symptoms, therefore, detecting NK early is critical. Management aims to halt continuing corneal damage and promote epithelial cell healing and nerve fibre regeneration. Novel treatment options show promise in restoring corneal sensitivity by re-establishing innervation, targeting the fundamental source of NK.

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Neurotrophic Keratopathy in Pediatric Patients

Cited by 11 publications

References 47 publications

Maternal serum eye drops to treat bilateral neurotrophic keratopathy in congenital corneal anesthesia: Case report and literature review

Maternal serum eye drops to treat bilateral neurotrophic keratopathy in congenital corneal anesthesia: Case report and literature review

Treatment of Non-Infectious Corneal Injury: Review of Diagnostic Agents, Therapeutic Medications, and Future Targets

Neurotrophic Keratitis: A Review

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