A New Treatment for Recalcitrant Neurotrophic Keratopathy of Ocular Graft-Versus-Host Disease with Virus Infection
Abstract Introduction Neurotrophic keratopathy (NK) is a rare degenerative ocular disease that can be difficult to treat. There were no effective resolutive treatments for severe NK caused by ocular graft-versus-host disease (oGVHD) along with virus infection. To address this question, we designed a...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2023-12-01
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| Series: | Ophthalmology and Therapy |
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| Online Access: | https://doi.org/10.1007/s40123-023-00857-z |
| _version_ | 1797355916718243840 |
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| author | Yi Qu Rongmei Peng Bohao Hu Siyi Ma Zheng Liu Shaofeng Gu Jing Hong |
| author_facet | Yi Qu Rongmei Peng Bohao Hu Siyi Ma Zheng Liu Shaofeng Gu Jing Hong |
| author_sort | Yi Qu |
| collection | DOAJ |
| description | Abstract Introduction Neurotrophic keratopathy (NK) is a rare degenerative ocular disease that can be difficult to treat. There were no effective resolutive treatments for severe NK caused by ocular graft-versus-host disease (oGVHD) along with virus infection. To address this question, we designed a prospective cohort study to evaluate the efficacy and safety of topical recombinant human nerve growth factor (rhNGF) in patients with recalcitrant NK of oGVHD and viral infection. Methods This prospective cohort study enrolled patients with recalcitrant NK diagnosed with oGVHD and treated with rhNGF. Clinical evaluations included the range of epithelial defects, best corrected visual acuity, intraocular pressure, slit-lamp examination, and corneal fluorescein staining. Examinations of the central corneal thickness, corneal sensitivity, and nerve fiber regeneration were performed at each visit at 4, 8, 12, 20 weeks and 6 months, respectively, after initiating rhNGF treatment. Results All enrolled patients were diagnosed with NK at stage 2 (7 eyes, 63.6%) or stage 3 (4 eyes, 36.4%) and responded to rhNGF treatment. Five of 11 (45.5%) and 9 of 11 eyes (81.8%) achieved complete corneal epithelial healing after 4 and 8 weeks, respectively. All 11 eyes (100%) achieved complete corneal healing after 12 weeks. There was also a significant reduction in the corneal ulcer area during each visit (P < 0.001), as well as in the corneal fluorescein staining score (P < 0.010). There was a significant improvement in corneal sensation when compared to the baseline (P < 0.050). Conclusion Topical treatment with rhNGF effectively promoted the complete corneal healing of persistent epithelial defects and corneal ulcers in patients with recalcitrant NK in oGVHD and viral infection. |
| first_indexed | 2024-03-08T14:18:07Z |
| format | Article |
| id | doaj.art-5915c1c33e32457d9b345fff9f54e0da |
| institution | Directory Open Access Journal |
| issn | 2193-8245 2193-6528 |
| language | English |
| last_indexed | 2024-03-08T14:18:07Z |
| publishDate | 2023-12-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Ophthalmology and Therapy |
| spelling | doaj.art-5915c1c33e32457d9b345fff9f54e0da2024-01-14T12:14:34ZengAdis, Springer HealthcareOphthalmology and Therapy2193-82452193-65282023-12-0113246947910.1007/s40123-023-00857-zA New Treatment for Recalcitrant Neurotrophic Keratopathy of Ocular Graft-Versus-Host Disease with Virus InfectionYi Qu0Rongmei Peng1Bohao Hu2Siyi Ma3Zheng Liu4Shaofeng Gu5Jing Hong6Department of Ophthalmology, Peking University Third HospitalDepartment of Ophthalmology, Peking University Third HospitalDepartment of Ophthalmology, Peking University Third HospitalDepartment of Ophthalmology, Peking University Third HospitalDepartment of Ophthalmology, Peking University Third HospitalDepartment of Ophthalmology, Peking University Third HospitalDepartment of Ophthalmology, Peking University Third HospitalAbstract Introduction Neurotrophic keratopathy (NK) is a rare degenerative ocular disease that can be difficult to treat. There were no effective resolutive treatments for severe NK caused by ocular graft-versus-host disease (oGVHD) along with virus infection. To address this question, we designed a prospective cohort study to evaluate the efficacy and safety of topical recombinant human nerve growth factor (rhNGF) in patients with recalcitrant NK of oGVHD and viral infection. Methods This prospective cohort study enrolled patients with recalcitrant NK diagnosed with oGVHD and treated with rhNGF. Clinical evaluations included the range of epithelial defects, best corrected visual acuity, intraocular pressure, slit-lamp examination, and corneal fluorescein staining. Examinations of the central corneal thickness, corneal sensitivity, and nerve fiber regeneration were performed at each visit at 4, 8, 12, 20 weeks and 6 months, respectively, after initiating rhNGF treatment. Results All enrolled patients were diagnosed with NK at stage 2 (7 eyes, 63.6%) or stage 3 (4 eyes, 36.4%) and responded to rhNGF treatment. Five of 11 (45.5%) and 9 of 11 eyes (81.8%) achieved complete corneal epithelial healing after 4 and 8 weeks, respectively. All 11 eyes (100%) achieved complete corneal healing after 12 weeks. There was also a significant reduction in the corneal ulcer area during each visit (P < 0.001), as well as in the corneal fluorescein staining score (P < 0.010). There was a significant improvement in corneal sensation when compared to the baseline (P < 0.050). Conclusion Topical treatment with rhNGF effectively promoted the complete corneal healing of persistent epithelial defects and corneal ulcers in patients with recalcitrant NK in oGVHD and viral infection.https://doi.org/10.1007/s40123-023-00857-zNerve growth factorNeurotrophic keratopathyOcular graft-versus-host disease |
| spellingShingle | Yi Qu Rongmei Peng Bohao Hu Siyi Ma Zheng Liu Shaofeng Gu Jing Hong A New Treatment for Recalcitrant Neurotrophic Keratopathy of Ocular Graft-Versus-Host Disease with Virus Infection Ophthalmology and Therapy Nerve growth factor Neurotrophic keratopathy Ocular graft-versus-host disease |
| title | A New Treatment for Recalcitrant Neurotrophic Keratopathy of Ocular Graft-Versus-Host Disease with Virus Infection |
| title_full | A New Treatment for Recalcitrant Neurotrophic Keratopathy of Ocular Graft-Versus-Host Disease with Virus Infection |
| title_fullStr | A New Treatment for Recalcitrant Neurotrophic Keratopathy of Ocular Graft-Versus-Host Disease with Virus Infection |
| title_full_unstemmed | A New Treatment for Recalcitrant Neurotrophic Keratopathy of Ocular Graft-Versus-Host Disease with Virus Infection |
| title_short | A New Treatment for Recalcitrant Neurotrophic Keratopathy of Ocular Graft-Versus-Host Disease with Virus Infection |
| title_sort | new treatment for recalcitrant neurotrophic keratopathy of ocular graft versus host disease with virus infection |
| topic | Nerve growth factor Neurotrophic keratopathy Ocular graft-versus-host disease |
| url | https://doi.org/10.1007/s40123-023-00857-z |
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