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Previous Volume 338:1174-1180 April 23, 1998 Number 17 Next

	Full Text PDF Editorial by Smith, R. E. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Corneal neurotrophic ulcers associated with impairment of sensory innervation of the cornea may lead to loss of vision, and there is no effective treatment for these ulcers. We evaluated the effects of nerve growth factor in patients with this disorder.

Methods Twelve patients (14 eyes) with severe corneal neurotrophic ulcers associated with corneal anesthesia were treated with topical nerve growth factor 10 times daily for two days and then 6 times daily until the ulcers healed. Treatment continued for 2 weeks after the ulcers healed, and the patients were then followed for up to 15 months. The evolution of the corneal disease during treatment and follow-up was evaluated by slit-lamp examination, photography, fluorescein-dye testing, and tests of corneal sensitivity and best corrected visual acuity.

Results Corneal healing began 2 to 14 days after the initiation of treatment with nerve growth factor, and all patients had complete healing of their corneal ulcers after 10 days to 6 weeks of treatment. Corneal sensitivity improved in 13 eyes, and returned to normal in 2 of the 13 eyes. Corneal integrity and sensitivity were maintained during the follow-up period (range, 3 to 15 months). Best corrected visual acuity increased progressively during treatment and follow-up in all patients. There were no systemic or local side effects of treatment.

Conclusions In this preliminary, uncontrolled study, topically applied exogenous nerve growth factor restored corneal integrity in patients with corneal neurotrophic ulcers.

Source Information

From the Department of Ophthalmology, University of Rome Tor Vergata, Rome (A.L., S.B.); the Division of Ophthalmology, Hospital of Venice SS. Giovanni e Paolo, Venice (A.L., P.R., G.C.); the Institute of Neurobiology, National Research Council, Rome (A.L., L.A.); and the G.B. Bietti Eye Foundation, Rome (S.B.) — all in Italy.

Address reprint requests to Dr. Aloe at the Institute of Neurobiology, National Research Council, Viale Marx 15, 00132 Rome, Italy.

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