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Vera-Duarte GR, Jimenez-Collado D, Kahuam-López N, Ramirez-Miranda A, Graue-Hernandez EO, Navas A, Rosenblatt MI. Neurotrophic keratopathy: General features and new therapies. Surv Ophthalmol 2024:S0039-6257(24)00042-0. [PMID: 38679146 DOI: 10.1016/j.survophthal.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
Neurotrophic keratopathy is an uncommon degenerative corneal disorder characterized by compromised corneal sensory innervation resulting in the formation of epithelial defects and nonhealing corneal ulcers. Various treatment modalities are available to stabilize disease progression, improve patient well-being, and prevent vision loss. For eligible patients, medical and surgical reinnervation have emerged as pioneering therapies, holding promise for better management. We present a comprehensive review of the disorder, providing an update relevant to ophthalmologists on pathogenesis, diagnosis, treatment options, and novel therapies targeting pathophysiological pathways.
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Affiliation(s)
- Guillermo Raul Vera-Duarte
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología "Conde de Valenciana, Mexico City, Mexico
| | - David Jimenez-Collado
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología "Conde de Valenciana, Mexico City, Mexico
| | - Nicolás Kahuam-López
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología "Conde de Valenciana, Mexico City, Mexico
| | - Arturo Ramirez-Miranda
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología "Conde de Valenciana, Mexico City, Mexico
| | - Enrique O Graue-Hernandez
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología "Conde de Valenciana, Mexico City, Mexico
| | - Alejandro Navas
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología "Conde de Valenciana, Mexico City, Mexico
| | - Mark I Rosenblatt
- Department of Ophthalmology and Visual Sciences, University of Illinois-Chicago (UIC), Chicago, IL 60612, USA.
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Steinemann A, Preiser D, Eggenschwiler L, Gohritz A, Decard BF, Kappos EA, Goldblum D. Minimally Invasive Corneal Neurotization for Neurotrophic Keratopathy. Klin Monbl Augenheilkd 2021; 238:365-366. [PMID: 33930911 DOI: 10.1055/a-1407-9228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Dunja Preiser
- Department of Ophthalmology, University of Basel, Basel, Switzerland
| | | | - Andreas Gohritz
- Department of Plastic Surgery, University of Basel, Basel, Switzerland
| | - Bernhard F Decard
- Departments of Medicine, Neurologic Clinic and Policlinic, University of Basel, Basel, Switzerland
| | | | - David Goldblum
- Department of Ophthalmology, University of Basel, Basel, Switzerland
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Wang J, Liu P, Liu Z, Tian Y, Zhang G, Guo J, Li L, Liu Z, Han Z, Lin W, Lin X, Lu Q, Liu Y, Chang Q, Wu S. Dorsolateral medullary infarction registry: a study protocol for a prospective, multicentric registry. BMC Neurol 2021; 21:18. [PMID: 33435910 PMCID: PMC7801561 DOI: 10.1186/s12883-020-02030-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 12/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background Dorsolateral medullary infarction is a typical cerebral infarction which is characterized by Wallenberg’s syndrome. Neurotrophic keratopathy is an uncommon consequence of dorsolateral medullary infarction. At present, the protocol is aimed to study the dynamic changes in corneal innervation and the ocular surface environment after dorsolateral medullary infarction. Methods This study will involve consecutive data from all medical records of patients within 7 days of acute dorsolateral medullary infarction onset at the Departments of Neurology from 10 collaborating stroke centers. Eligible patients will mainly be characterized based on detailed physical examinations, multimodal imaging, and corneal related examinations and patients will be followed-up for 2 years. Neurotrophic keratopathy after dorsolateral medullary infarction is the primary endpoint. The dynamic histological corneal innervation and ocular surface environment after dorsolateral medullary infarction will be observed during the follow-up period. Discussion This multicentric, prospective registry is the first to identify and characterize the dynamic changes of corneal innervation and the ocular surface environment after acute dorsolateral medullary infarction. The significance of the study is to emphasize that the curative effect is based on the doctors’ identification of the disease in the earliest stage before irreversible damage occurs to the cornea. Trial registration The registry was registered (ChiCTR-OPC-17,011,625) on June 11, 2017.
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Affiliation(s)
- Jing Wang
- Department of Neurology, First Hospital of Xi'an, 710002, Xi'an, Shaanxi Province, China.,Department of Neurology, the First Affiliated Hospital of Northwestern University, 710002, Xi'an, Shaanxi Province, China
| | - Pei Liu
- Department of Neurology, First Hospital of Xi'an, 710002, Xi'an, Shaanxi Province, China.,Department of Neurology, the First Affiliated Hospital of Northwestern University, 710002, Xi'an, Shaanxi Province, China
| | - Zhongzhong Liu
- Department of Neurology, First Hospital of Xi'an, 710002, Xi'an, Shaanxi Province, China.,Department of Neurology, the First Affiliated Hospital of Northwestern University, 710002, Xi'an, Shaanxi Province, China
| | - Ye Tian
- Department of Neurology, Third Hospital of Xi'an, the Affiliated Hospital of Northwest University, 710018, Xi'an, Shaanxi Province, China
| | - Guilian Zhang
- Department of Neurology, the Second Affiliated Hospital of Xi'an Jiaotong University, 710004, Xi'an, Shaanxi Province, China
| | - Jun Guo
- Department of Neurology, Tangdu Hospital, Air Force Military Medical University, 710038, Xi'an, Shaanxi Province, China
| | - Li Li
- Department of Neurology, Xijing Hospital, Air Force Military Medical University, 710032, Xi'an, Shaanxi Province, China
| | - Zhiqin Liu
- Department of Neurology, Xi'an Central Hospital, Xi'an Jiaotong University School of Medicine, 710003, Xi'an, Shaanxi Province, China
| | - Zucheng Han
- Encephalopathy Hospital, Shanxi Provincial Hospital of Traditional Chinese Medicine, 710077, Xi'an, Shaanxi Province, China
| | - Wenjuan Lin
- College of Life Sciences, Northwest University, 710069, Xi'an, Shaanxi Province, China
| | - Xuemei Lin
- Department of Neurology, First Hospital of Xi'an, 710002, Xi'an, Shaanxi Province, China.,Department of Neurology, the First Affiliated Hospital of Northwestern University, 710002, Xi'an, Shaanxi Province, China
| | - Qingli Lu
- Department of Neurology, First Hospital of Xi'an, 710002, Xi'an, Shaanxi Province, China.,Department of Neurology, the First Affiliated Hospital of Northwestern University, 710002, Xi'an, Shaanxi Province, China
| | - Yan Liu
- Department of Neurology, First Hospital of Xi'an, 710002, Xi'an, Shaanxi Province, China.,Department of Neurology, the First Affiliated Hospital of Northwestern University, 710002, Xi'an, Shaanxi Province, China
| | - Qiaoqiao Chang
- Department of Neurology, First Hospital of Xi'an, 710002, Xi'an, Shaanxi Province, China.,Department of Neurology, the First Affiliated Hospital of Northwestern University, 710002, Xi'an, Shaanxi Province, China
| | - Songdi Wu
- Department of Neurology, First Hospital of Xi'an, 710002, Xi'an, Shaanxi Province, China. .,Department of Neurology, the First Affiliated Hospital of Northwestern University, 710002, Xi'an, Shaanxi Province, China.
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