Neurotrophic Corneal Ulcers Research Articles

Persistent Visual Loss from Neurotrophic Corneal Ulceration After Dorsolateral Medullary Infarction (Wallenberg Syndrome)

Persistent Visual Loss from Neurotrophic Corneal Ulceration After Dorsolateral Medullary Infarction (Wallenberg Syndrome)

Inadvertent conjunctival trauma related to contact with drug container tips: A masquerade syndrome

Purpose To report the diagnosis, clinical course, and management of acute painful red eye syndrome associated with unintentional tube- or bottle-tip-induced conjunctival trauma. Design A small, noncomparative, interventional case series. Participants Twelve eyes of 12 patients (8 female and 4 male, aged 21–84 years) who were urgently reported or referred with a variety of diagnoses resulting from acute onset of red, painful eye. Four eyes had corneal transplants, two were recovering from herpetic keratitis, two had undergone cataract surgery or a laser in situ keratomileusis procedure, one had a corneal neurotrophic ulcer, and one used a contact lens. All the patients had received new medications (ophthalmic ointments in nine patients, topical drops in three patients) within 1 week before onset of symptoms. Intervention Assessment of method of self-administration of topical medication, evaluation of the ocular surface lesion, and patient education. Main outcome measures Association of patient behavior with ocular surface lesions. Results All 12 patients presented red, painful eyes, congested lower palpebral conjunctiva, epithelial conjunctival erosions, and episcleritis. In all patients, direct contact of the tube or bottle-tip with the affected area of the conjunctiva was ascertained by inspection. Instructions on proper method of drug administration and eye patching with lubrication were followed, within 2 weeks, by healing of conjunctival lesions. Conclusions Drug containers may cause nonintentional conjunctival trauma and simulate severe ocular disorders. Physicians should be aware of this diagnosis in any case of prolonged and unexplained ocular irritation and should instruct patients as to the proper instillation of topical ophthalmic medications.

Histologic findings after amniotic membrane graft in the human cornea

ObjectiveTo describe the histopathologic findings in the human cornea several months after a stromal amniotic membrane graft. To show the clinicopathologic correlation after the graft in two cases with different follow-up times. DesignTwo interventional case reports with clinicopathologic correlation. ParticipantsTwo patients with neurotrophic corneal ulcer unresponsive to medical treatment (one with stromal vascularization and the other without stromal vascularization). InterventionAmniotic membrane graft was performed in both patients to treat the neurotrophic ulcer. Three and 7 months after amniotic membrane grafting, a penetrating keratoplasty was needed, and the removed corneas were analyzed. Main outcome measuresClinical and histopathologic examinations, including routine histopathologic and immunohistochemical studies. ResultsComplete epithelialization was observed on histologic examination over the basement membrane of the amniotic membrane graft. The amniotic membrane was slowly reabsorbed in the cornea without stromal vascularization with no inflammatory reaction produced. In the cornea that had stromal vascularization the amniotic membrane was rapidly reabsorbed because of the presence of abundant inflammatory cells. Once reabsorbed, the amniotic membrane was replaced by new fibrotic stroma, that was different from that found in the rest of the cornea but that helped to maintain corneal thickness. ConclusionsThe amniotic membrane graft allows for correct epithelialization in cases of neurotrophic corneal ulcer. Once the amniotic membrane is reabsorbed, it is replaced by a new fibrotic stroma, which can reduce corneal transparency. In corneas that have no stromal vascularization, the graft may remain in the stroma for many months, compromising corneal transparency during this period.

Amniotic membrane transplantation for severe neurotrophic corneal ulcers

AIMSTo evaluate whether amniotic membrane transplantation can be an effective alternative treatment for neurotrophic corneal ulcers.METHODSAmniotic membrane transplantation was performed in 16 eyes of 15 patients with neurotrophic corneal ulcers...

Nerve growth factor: basic findings and clinical trials

The nerve growth factor is the first-discovered and best-characterized member of the family of neurotrophins. In the introduction of this article we present a brief biographic view of past and present studies of Rita Levi-Montalcini on nerve growth factor: Further, the article focuses on pleiotropic activities of nerve growth factor, exerting on various cell types, including cells of nervous, immune and endocrine system. Implications of these actions of nerve growth factor in the pathogenesis of neurological diseases, autoimmune-inflammatory diseases, allergic diseases, lymphoproliferative diseases, atherosclerotic cardiovascular disease, and neurotrophic corneal ulcers are outlined. Biomedical Reviews 1999; 10: 3-14.

Penetrating Keratoplasty for Herpes Zoster Keratopathy

We reviewed retrospectively the records of 12 patients with herpes zoster keratopathy who had undergone penetrating keratoplasty. Preoperatively, seven patients (58%) had noninflamed eyes with visually significant corneal scarring or edema. Five patients (42%) had progressive neurotrophic corneal ulceration, and four of those had corneal perforation. Tarsorrhaphies were placed in ten patients and appeared to be beneficial in preventing postoperative breakdown of the corneal surface. At an average follow-up time of 36 months, ten of the 12 grafts (83%) remained clear, with nine patients (75%) having a visual acuity of 20/80 or better.