ReviewDer Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft2019
[Clinical picture and diagnosis of neurotrophic keratopathy].
Review in Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNeurotrophic keratopathy is characterized by corneal surface alterations, persistent corneal epithelial defects and/or corneal ulcerations associated with corneal sensory abnormalities. Due to the variable clinical picture neurotrophic keratopathy is often overlooked or diagnosed too late in the course of the disease.
objectiveDiscussion of the clinical picture of neurotrophic keratopathy and recommendations for correct diagnosis. MATERIAL AND
methodsAnalysis of the existing literature and discussion of basic recent publications.
resultsNeurotrophic keratopathy is defined as a disease related to alterations in corneal nerves leading to impairment in sensory and trophic function with consequent breakdown of the corneal epithelium affecting health and integrity of the tear film, epithelium and stroma. It can occur with infections, autoimmune diseases, after trauma or ocular surgery, with intracranial neoplasia, in systemic diseases and genetic syndromes. It is classified into three stages: mild (epithelial changes without epithelial defects), moderate (epithelial defects) and severe (stromal involvement). The clinical hallmark is reduced or absent corneal sensation. Therefore, corneal sensitivity testing is essential in the diagnosis of neurotrophic keratopathy along with the patient history, clinical examination and diagnostic tests, such as vital stains and, if possible, in vivo confocal microscopy.
conclusionThe correct diagnosis and classification of neurotrophic keratopathy enable a stage-adapted step-ladder therapeutic approach with subsequent reduction of progression and complications of the disease.
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