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Neurotrophic Keratopathy

Neurotrophic Keratitis


Presentation

  • This paper discusses the ophthalmic histories of three patients who presented with diabetic neurotrophic keratopathy. In one patient the corneal ulceration was the sole presenting feature of his diabetes.[ncbi.nlm.nih.gov]
  • A 68 year-old man presented with irritation and blurred vision in both eyes 2 weeks after bilateral Vidian neurectomy.[ncbi.nlm.nih.gov]
  • In the present article, we review the pathobiology and prevention/treatment of neurotrophic corneal diseases.[ncbi.nlm.nih.gov]
  • Clinical features and guidelines for the differential diagnosis and treatment are presented. Specific medical and surgical treatments, selected on the basis of clinical staging of the disease, can often halt disease progression.[ncbi.nlm.nih.gov]
  • Hundreds of full-color images present conditions as they present in real life. Common diagnostic pitfalls discuss what to look out for when making a difficult diagnosis.[books.google.com]
Miosis
  • To present a case of bilateral neurotrophic keratopathy with miosis after bilateral Vidian neurectomy for vasomotor rhinitis. Observational case report.[ncbi.nlm.nih.gov]
Bitot's Spots
  • Ocular examination: Conjunctiva: Conjunctiva may show Bitot spots, which are associated with hypovitaminosis A. Anterior chamber: Anterior chamber activity may lead to corneal anaesthesia due to uveitis associated with chronic inflammatory disease.[nhp.gov.in]
Polyneuropathy
  • The corneal wound in this case is a result of a corneal anaesthesia due to the systemic polyneuropathy.[ncbi.nlm.nih.gov]
Areflexia
  • […] neurotrophic keratitis (Ophthalmology. 2018;125:1332-1343). ( 30683186 ) Ting DSJ 2019 6 A Case of Neurotrophic Keratopathy Associated with Nasopharyngeal Carcinoma. ( 29643792 ) Sato T....Shimomura Y. 2018 7 Cerebellar Ataxia With Neuropathy and Vestibular Areflexia[malacards.org]
Cerebellar Ataxia
  • Ataxia With Neuropathy and Vestibular Areflexia Syndrome Presenting With Neurotrophic Keratopathy. ( 29474200 ) Paley G.L....Van Stavern G.P. 2018 8 Corneal Neurotization for Neurotrophic Keratopathy: Clinical Outcomes and In Vivo Confocal Microscopic[malacards.org]

Treatment

  • Although at present, there are no accurate treatment methods for neurotrophic keratopathy, several effective treatments have been reported.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: Treatment with nicergoline helps patients with neurotrophic keratopathy in whom conventional treatment has failed.[ncbi.nlm.nih.gov]
  • Clinical features and guidelines for the differential diagnosis and treatment are presented. Specific medical and surgical treatments, selected on the basis of clinical staging of the disease, can often halt disease progression.[ncbi.nlm.nih.gov]
  • A focus on treatments that reduce the inflammatory responses while accelerating corneal epithelial growth would represent a major step forward from current treatment options.[ncbi.nlm.nih.gov]
  • The mean pretreatment corneal sensitivity was 11.8 /-11.6 mm, which increased to 30.0 /-22.9 mm after treatment at the last follow-up. Five eyes attained normal corneal sensitivity with treatment.[ncbi.nlm.nih.gov]

Prognosis

  • Presence of associated ocular surface disease may affect the prognosis.[nhp.gov.in]
  • In stage 3, admission to an inpatient unit should be considered until the risk of perforation is reduced. [26] Prognosis Prognosis of patients affected by NK depends on disease stage, degree of anaesthesia and association with other ocular surface diseases.The[eyewiki.aao.org]
  • Furthermore, laser confocal microscopy can helped to guide the degree of nerve damage and dynamic observation of corneal nerve regeneration, estimate the treatment, and the prognosis of the patients.[bmcneurol.biomedcentral.com]
  • […] in the superior cornea Edges of the epithelial defect become smooth and rolled with time Stromal edema with Descemet’s membrane folds Sometimes associated with aqueous cell and flare Stage 3 Stromal lysis, sometimes resulting in corneal perforation Prognosis[healio.com]
  • Coexisting ocular surface diseases such as dry eye, exposure keratitis, and limbal stem cell deficiency may worsen the prognosis. The disease progression is often asymptomatic and may lead to corneal infection and melting/perforation.[biotissue.com]

Etiology

  • The etiology and recent advances in understanding of the pathogenetic mechanisms of neurotrophic keratopathy are reviewed here.[ncbi.nlm.nih.gov]
  • Another common etiology of neurotrophic keratopathy is diabetes mellitus. Diabetes either may be the primary cause of neurotrophic keratopathy or secondarily may predispose patients to this condition.[aao.org]
  • Congenital hypoplasia of the trigeminal nerve has also been described in association with NK. [12] Risk Factors Risk factors for NK are those related with the underlying etiology.[eyewiki.aao.org]
  • Etiology Multiple ocular and systemic causes can be responsible for neurotrophic keratopathy.[ophthalmologymanagement.com]
  • […] de la Paz MF 2016 40 Etiologies, Quantitative Hypoesthesia, and Clinical Outcomes of Neurotrophic Keratopathy. ( 25828513 ) Hsu H.Y....Modi D. 2015 41 Potential New Modes of Treatment of Neurotrophic Keratopathy. ( 26448169 ) Yanai R....Sonoda K.H. 2015[malacards.org]

Epidemiology

  • Epidemiology The epidemiology of NK is still uncertain.[eyewiki.aao.org]
  • Se apreciaz c exist urmtoarele metode de depis-tare a tuberculozei: depistarea clinic, depistarea bacteriologic, depistarea biologic prin IDR, depistarea prin radiofotografie depistare prin anchet epidemiologic Diagnosticul de supoziie aparine medicului[vdocuments.net]
Sex distribution
Age distribution

Pathophysiology

  • EUROTIMES STORIES Professor Harminder Dua Professor Harminder Dua, Queen’s Medical Centre, Nottingham, UK, addressed delegates at the 8 th EuCornea Congress in Lisbon on the topic of “Pathophysiology of neurotrophic keratoplasty” (NK).[eurotimes.org]
  • Neurotrophic Keratitis: Diagnosis and Management. ( 26451380 ) Mantelli F...Lambiase A 2015 45 Synergistic effect of regenerating agent plus cord blood serum eye drops for the treatment of resistant neurotrophic keratitis: a case report and a hypothesis for pathophysiologic[malacards.org]
  • Pathophysiology The cornea has a high density of nerve endings from the long posterior ciliary nerves and is 100 times more sensitive than the conjunctiva.[aao.org]
  • Ltd, 2 Zhang Ba Wu Road, Xi’an, Shaanxi, China References Okada Y, Reinach PS, Kitano A, Shirai K, Kao WW, Saika S: Neurotrophic keratopathy; its pathophysiology and treatment. Histol Histopathol. 2010, 25: 771-780.[bmcneurol.biomedcentral.com]
  • […] scan OU Retina flat, no detachments, no masses OU Crack eye syndrome characterized by: Epitheliopathy/epithelial trauma Superficial punctate keratitis Epithelial defects Microbial keratitis Stromal melt and corneal perforation Neurotrophic keratopathy Pathophysiology[eyewiki.org]

Prevention

  • In the present article, we review the pathobiology and prevention/treatment of neurotrophic corneal diseases.[ncbi.nlm.nih.gov]
  • The identification of corneal anesthesia associated with an epithelial defect allows appropriate treatment and prevention of progression to stromal lysis and perforation.[ncbi.nlm.nih.gov]
  • In doing so, corneal neurotization may halt the process of NK and prevent further visual loss.[ncbi.nlm.nih.gov]
  • Timely and appropriate action is required in the management of this condition to prevent serious complications such as corneal ulceration, perforation, and loss of vision.[ncbi.nlm.nih.gov]
  • From minor corneal injuries to more severe inflammatory-mediated pathologies, clinicians need agents that promote corneal healing and reduce the inflammatory response to prevent visual disturbances and improve quality of life.[ncbi.nlm.nih.gov]

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