Neurotrophic Keratopathy: Current Perspectives

Abstract

Neurotrophic keratopathy (NK) is a challenging ophthalmological disease. In this review, we present an updated evidence-based summary on the pathophysiology, classification, diagnosis, and how novel therapies have changed the management of NK. New specific medical and surgical modalities are emerging, such as Cenegermin (Oxervate®, Dompe) and neurotization procedures, which are changing the paradigm of the treatment of NK. In addition, more diagnostic resources are available, such as corneal confocal microscopy in vivo, non-contact esthesiometers, and common ocular surface points of care test, which have been validated in this condition. NK is a disease produced by an impairment of corneal innervation caused by a variety of local and systemic disorders, such as viral infection, medicamentosa, chronic contact lens use, surgical or iatrogenic, diabetes, multiple sclerosis, and more, that leads to a progressive chronic epitheliopathy with a variable degree of injury. Early diagnosis can be challenging due to low prevalence, clinical suspicion, and the need for complementary diagnostic methods to confirm. New medical and surgical treatment modalities have emerged that are specifically directed to the pathophysiology of NK with promising results.