Corneal Reinnervation after Recombinant Form of Nerve Growth Factor Treatment in Patients with Neurotrophic Keratitis

Purpose . To evaluate corneal reinnervation in patients with neurotrophic keratitis after treatment with a recombinant form of human nerve growth factor (cenegermin) using confocal microscopy. Patients and methods . The results of 4 patients treatment with neurotrophic keratitis of various etiology were analyzed. All patients showed ineffectiveness of reparative and etiotropic therapy for 3 months, therefore, cenegermin was prescribed as pathogenetic treatment. Patients underwent standard and specialised diagnostics. In addition, confocal microscopy of the cornea was performed with subsequent analysis of the density of the subbasal nerve plexus, maximum, minimum and total lengths of the corneal nerves using the ImageJ program. The maximum follow-up period was 12 months. Results . After 8 weeks of treatment, complete epithelialisation and an increase in corneal sensitivity were observed in all patients. Analysis of the confocal scans showed that the maximum density of the subbasal nerve plexus was observed after 8 weeks of treatment. With increasing follow-up, the density of the subbasal nerve plexus increased to a lesser extent and the length of the nerves increased to a greater extent. Conclusion . Treatment with a recombinant form of human nerve growth factor for 8 weeks results in regeneration and significant increase of the subbasal nerve plexus density. With the increase of follow-up period corneal reinnervation continues due to elongation of nerve fibers.