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Antiinflammatory therapy of neurotrophic corneal diseases

https://doi.org/10.21516/2072-0076-2019-12-4-77-82

Abstract

Clinical data on new directions in combined treatment of neurotrophic keratitis, including anti-inflammatory therapy are presented.

Purpose. To compare the effectiveness of bromfenac 0.09 %, nepafenac 0.1 % and indomethacin 0.1 % eye drops in the treatment of neurotrophic keratitis (NK).

Materials and methods. 22 NK patients, aged 34 to 78, were divided into three groups. Group I received bromfenac 0.09 %, group II, nepafenac 0.1 %, and group III, indomethacin 0.1 %. Ophthalmic tests included visometry, biomicroscopy, corneal sensitivity determination, as well as diagnostic tests to determine indicators of tear production (Schirmer test, Norn test, LIPCOF test), and measuring lacrimal meniscus height.

Results. Between visits V2 and V3, patients of group III showed an increase in conjunctival irritation to an average of 2.3 points, while groups I and II revealed the condition of the conjunctiva at 0.9 and 1.1 points, respectively. The lesion area was evaluated in points (max = 20) and averaged on V1 6.8 points in group I, 5.9 points in group II and 7.2 points in group III. Keratopathy in group I which was estimated at 3.8 points before V2, dropped to 1.4 points by V3. In group III it was 1.7 points by V3. In group II, keratopathy showed only 4.1 points by V3. The average Norn test on the day of treatment showed 2.7 seconds in group I, 2.5 seconds in group II, and 3.1 seconds in group III. No significant increase in Schirmer's test results in all groups was recorded.

Conclusion. The use of non-steroidal anti-inflammatory eye drops of various groups — bromfenac 0.09%, nepafenac 0.1 % and indomethacin 0.1 % — gave a positive result in NK therapy. However, bromfenac 0.09% instillations administered once a day produce a higher anti-inflammatory effect then the same quantity of nepafenac 0.1% and indomethacin 0.1 % instillations.

About the Authors

E. V. Yani
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation

Cand. of Med. Sci., head, department of viral and allergic eye diseases

19, Sadovaya Chernogryazskaya St., Moscow, 105062, Russia



E. N. Orlova
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation

Cand. of Med. Sci., scientific secretary

19, Sadovaya Chernogryazskaya St., Moscow, 105062, Russia



V. A. Golikova
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation

PhD student

19, Sadovaya Chernogryazskaya St., Moscow, 105062, Russia



References

1. Muller L.J., Marfurt C.F., Kruse F., Tervo T.M. Corneal nerves: structure, contents and function. Experimental eye research. 2003; 76 (5): 521–42. doi:10.1016/s0014-4835(03)00050-2

2. Tervo T., Palkama A. Innervation of the rabbit cornea. A histochemical and electron-microscopic study. Acta Anatomica. 1978; 102 (2): 164–75. PMID: 685646

3. Suuronen E.J., Nakamura M., Watsky M.A., et al. Innervated human corneal equivalents as in vitro models for nerve-target cell interactions. FASEB journal: official publication of the FASEB. 2004; 18 (1): 170–2. doi: 10.1096/fj.03-0043fje

4. Acosta M.C., Tan M.E., Belmonte C., Gallar J. Sensations evoked by selective mechanical, chemical, and thermal stimulation of the conjunctiva and cornea. Invest. Ophthalmol. Vis. Sci. 2001; 42 (9):2063–7. PMID: 11481273

5. Marfurt C.F., Kingsley R.E., Echtenkamp S.E. Sensory and sympathetic innervation of the mammalian cornea. A retrograde tracing study. Invest. Ophthalmol. Vis. Sci. 1989; 30 (3): 461–72.

6. Alsuhaibani A.H. Facial nerve palsy: providing eye comfort and cosmesis. Middle East Afr J Ophthalmol. 2010 Apr-Jun; 17 (2):142–7. doi:10.4103/0974-9233.63078

7. Cochener B., Zagnoli C., Hugny-Larroque C., Derrien S. Healing of resistant corneal neurotrophic ulcers using a matrix regenerating agent. J. Fr. Ophtalmol. 2019; 42 (2 Feb.): 159–65. https://doi.org/10.1016/j.jfo.2018.05.009

8. De Haas E.H. Desiccation of cornea and conjunctiva after sensory denervation: significance of desiccation for pathogenesis of neuroparalytic keratitis. Arch. Ophthalmol. 1962; 67 (4): 439–52. doi:10.1001/archopht.1962.00960020439010

9. Mackie I.A. Role of the corneal nerves in destructive disease of the cornea. Trans. Ophthalmol. Soc. U K. 1978 Sep; 98 (3): 343–7. PMID: 224534

10. Нероев В.В., Орлова Е.Н., Ибрагимова Д.И., Яни Е.В., Вахова Е.С. Патогенетически обоснованный дифференцированный под- ход к диагностике и терапии различных клинических форм поражения роговицы при синдроме сухого глаза. Российский офтальмологический журнал. 2014; 7 (4): 81–6.

11. Neroev V.V., Orlova E.N., Ibragimova D.I., Yani E.V., Vakhova E.S. A pathogenetically validated differentiated approach to the diagnosis and therapy of various clinical forms of corneal lesions in dry eye syndrome. Russian ophthalmological journal. 2014; 7 (4): 81–6 (in Russian).

12. Wipperman J.L., Dorsch J.N. Evaluation and management of corneal abrasions. Am Fam Physician. 2013 Jan15; 87 (2): 114–20. https://www.aafp.org/afp/2013/0115/p114.html

13. Zemaitiene R., Rakauskiene M., Danileviciene V., et al. Corneal esthesiometry and sub-basal nerves morphological changes in herpes simplex virus keratitis/uveitis patients Int. J. Ophthalmol. 2019 Mar 18; 12 (3): 407–11. doi:10.18240/ijo.2019.03.09

14. Catapano J., Fung S.S.M., Halliday W., et al. Treatment of neurotrophic keratopathy with minimally invasive corneal neurotisation: long-term clinical outcomes and evidence of corneal reinnervation. Br. J. Ophthalmol. 2019 Feb 15. http://dx.doi.org/10.1136/bjophthalmol-2018-313042


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For citations:


Yani E.V., Orlova E.N., Golikova V.A. Antiinflammatory therapy of neurotrophic corneal diseases. Russian Ophthalmological Journal. 2019;12(4):77-82. (In Russ.) https://doi.org/10.21516/2072-0076-2019-12-4-77-82

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ISSN 2072-0076 (Print)
ISSN 2587-5760 (Online)