Neurotrophic keratopathy: Clinical presentation and effects of cenegermin.

Purpose: To report on 4 patients (3 adults, 1 child) with neurotrophic keratopathy (NK) treated with cenegermin 20 μg/ml (Oxervate®), a recombinant human nerve growth factor (rhNGF), which was authorized by the European Medicines Agency for the treatment of neurotrophic keratopathy stage 2 and stage 3 of Mackie Classification in patients over 18 years of age. Observations: Three patients with neurotrophic keratopathy stage 2 and 1 patient with neurotrophic keratopathy stage 3, who were treated with cenegermin eye drops 6 times daily for 8 weeks, were observed. Two patients suffered from herpetic keratitis and 2 patients from neurotrophic keratopathy secondary to orbital radiation. In addition to closure of epithelial defects, an increase of corneal sensitivity and improvement of visual acuity has been shown in all treated patients at the end of therapy. One patient reported on neuralgic pain as a side effect. The corneal epithelium remained closed during the follow-up period of 11 weeks, 31 and 32 months after cessation of therapy in 3 patients, respectively. In one patient, corneal erosion recurred 4 weeks after completion of treatment due to recurrent HSV keratitis, which resolved after therapy adjustment and the corneal epithelium remained closed for 35 weeks. Conclusion: The cases presented suggest that treatment with cenegermin 20 μg/ml not only promotes corneal epithelial wound healing, but also significantly improves corneal sensitivity and visual acuity with minor side effects in adults and children.