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Neurotrophic keratopathy‐diagnosis and clinical presentations
Author(s) -
Messmer Elisabeth M.
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2019.8102
Subject(s) - medicine , pathology , corneal epithelium , disease , stroma , neurotrophic factors , cornea , neurotrophin , epithelium , ophthalmology , immunohistochemistry , receptor
Neurotrophic 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 disease, after trauma or ocular surgery, with intracranial neoplasia, in systemic disease and genetic syndromes. It is classified in three stages: mild (epithelial changes without epithelial defect), moderate (epithelial defect) and severe (stromal involvement). Clinical hallmark is reduced or absent corneal sensation. Therefore, corneal sensitivity testing is essential in the diagnosis of neurotrophic keratopathy along with patient history, clinical examination and diagnostic tests such as vital stains and, if possible, in vivo confocal microscopy.