CONSERVATIVE TREATMENT OF NEUROTROPHIC KERATITIS

Abstract

Neurotrophic keratitis (NK) is a degenerative disease of the cornea characterized by a certain complex of symptoms, including decrease in its sensitivity, spontaneous instability of the corneal epithelium with a significant deterioration of the healing process. The development of keratopathy (KP) is accompanied by such complaints as fluctuation of visual acuity, photophobia and lacrimation, and pain of varying severity. Being one of the most densely innervated tissues of the body, the cornea is sufficiently sensitive to innervation with the development of severe trophic keratitis and ulcers.There are many reasons for the development of neurotrophic corneal changes, and they are not only in the sphere of ophthalmologic pathologies. Eye reasons of the NK development can include herpetic keratitis, the condition after certain eye surgeries, wearing of contact lenses. Non-ophthalmologic reasons for the NK development of NK include surgeries as the primary reason, prolonged anesthesia, post-acute disorders of cerebral circulation.NK diagnosis is quite hard work, combining a thorough history, a detailed ophthalmic examination with assessment of corneal sensitivity and high-tech diagnostics, using confocal biomicroscopy.Depending on the severity NK are divided into the keratopathy, the confluent corneal erosion and corneal ulcers.The algorithm of NK therapy should be based on the severity of clinical presentations and is aimed at accelerating healing of the cornea and preventing disease progression with the development of deeper layers involvement. Treatment can be both conservative and surgical, such as amniotic membrane transplantation or a conjunctival flap.This article presents data of clinical observations potentially promising in the treatment of NK by Visomitin drug.

Keywords

• neurotrophic keratitis
• pharmacotherapy
• mitochondria-targeted antioxidant
• visomitin