Abstract
BackgroundHealthy corneal epithelium acts as a barrier against damage to the deeper structures in the eye. Failure in the mechanisms of corneal epithelization can lead to persistent epithelial defects of the cornea (PEDs) and can compromise its function. Epidermal growth factor (EGF) promotes the proliferation, migration, and differentiation of epithelial cells, endothelial cells, and fibroblasts during wound healing and may be beneficial in treating patients with PEDs. We, therefore, investigated the effect of EGF ointment on patients with PEDs.MethodsFifteen patients with PEDs refractory to conventional treatment were treated twice a day with EGF ointment. Patient demographics and comorbidities were noted. The epithelial healing time was determined along with the primary outcome measures in the areas of the epithelial defects, visual acuity, visual analog scale (VAS) scores, and esthesiometer scores 1 month and 2 months after treatment.ResultsFive eyes of herpetic keratitis (33.3%), 3 eyes of dry eye disease (20.0%), 3 eyes of bacterial keratitis (20.0%), 2 eyes of limbal stem cell deficiency (13.3%), 1 eye of diabetic neurotrophic keratitis (6.7%), and 1 eye of filamentary keratitis (6.7%) were associated with PEDs, respectively. Two months following treatment with EGF ointment, there was a reduction in the area of the epithelial defects (5.7 ± 3.9 to 0.1 ± 0.3 mm2) as well as a significant improvement in best-corrected visual acuity (0.9 ± 0.8 to 0.6 ± 0.5 LogMAR) and VAS scores (4.5 ± 1.2 to 2.5 ± 0.7) in 12 eyes (80%). Among these cases, the mean epithelial healing time was 5.5 ± 1.8 weeks. Amniotic membrane transplantation was performed on the remaining 3 (20.0%) patients that did not respond to EGF treatment.ConclusionsEGF ointment could reduce symptoms and promotes corneal epithelialization of refractory PEDs. It may, therefore, be well-tolerated and a potentially beneficial addition in the management of refractory PEDs.
Highlights
Healthy corneal epithelium acts as a barrier against damage to the deeper structures in the eye
The current available noninvasive conventional treatments for persistent epithelial defects of the cornea (PEDs) include the administration of lubricating agents, hyperosmotic agents, autologous serum, and umbilical cord serum, as well as the application of therapeutic contact lenses [4,5,6,7,8]
Considering the abovementioned factors, the present study aimed to evaluate whether Epidermal growth factor (EGF) is effective in treating patients with PEDs
Summary
Healthy corneal epithelium acts as a barrier against damage to the deeper structures in the eye. Persistent epithelial defects of the cornea (PEDs) can result from trauma to the cornea as seen with corneal abrasions or following surgery They can develop in patients with dry eye, exposure keratitis, neurotrophic. Moon et al BMC Ophthalmology (2020) 20:147 characterized by fluorescein staining of the defect area and ground glass-like opacity surrounding the defect Complications such as secondary infection, scarring, and perforation can occur if the condition is not treated appropriately [3]. Keratectomy, and amniotic membrane transplantation [9,10,11]. In spite of these many treatment options, some cases of PEDs do not respond to conventional treatment
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