Neuropathic keratopathy

Publication date: Available online 23 April 2018Source: Progress in Retinal and Eye ResearchAuthor(s): Harminder S. Dua, Dalia G. Said, Elisabeth M. Messmer, Maurizio Rolando, Jose M. Benitez-del-Castillo, Parwez N. Hossain, Alex J. Shortt, Gerd Gerling, Mario Nubile, Francisco C. Figueiredo, Saaeha Rauz, Leonardo Mastropasqua, Paolo Rama, Christophe BaudouinAbstractNeurotrophic Keratopathy (NK) refers to a condition where corneal epitheliopathy leading to frank epithelial defect with or without stromal ulceration (melting) is associated with reduced or absent corneal sensations. Sensory nerves serve nociceptor and trophic functions, which can be affected independently or simultaneously. Loss of trophic function and consequent epithelial breakdown exposes the stroma making it susceptible to enzymatic degradation. Nerve pathology can range from attrition to aberrant re-generation with corresponding symptoms from anaesthesia to hyperaesthesia/allodynia. Many systemic and ocular conditions, including surgery and preserved medications can lead to NK. NK can be mild (epithelium and tear film changes), moderate (non-healing epithelial defect) or severe (stromal melting and perforation). Moderate and severe NK can profoundly affect vision and adversely impact on the quality of life. Medical management with lubricating agents from artificial tears to serum/plasma drops, anti-inflammatory agents, antibiotics and anti-proteases all provide non-specific relief, which may be temporary. C...
Source: Progress in Retinal and Eye Research - Category: Opthalmology Source Type: research