VIDEO: ‘Exciting’ conference updates in neurotrophic keratitis

Editor’s note: This is an automatically generated transcript, which has been slightly edited for clarity. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

If you want to click on the prior link about topical insulin, that’s obviously one. That stemmed from a lot of discussion on different type of growth factors. I definitely encourage everybody to keep watch on those kind of derivatives that we may be able to use in the future. The reason that a lot of our traditional managements don’t really work long term is that we try our best to close up the wound to promote epithelial healing. But remember neurotrophic, there’s no trophic support from the nerves to the ocular surface. We don’t really know how far we can go upstream in terms of restoring the proliferation of the neural network in being able to redeliver or revive trophic support.

It had always been questioned about, even with the recent success we’ve had with topical Oxervate (cenegermin, Dompé], which is the recombinant human nerve growth factor, how long can we keep that up? Because it’s showing that a year, 2 years, patients are maybe still stable from their trials, but is there really evidence that shows that we are actually reviving the viability of the corneal nerves?

In a recent publication that was released by Pedrotti and colleagues where they actually treated the NK patients using topical Oxervate, follow the patient up after treatment up to about 8 months and have shown using confocal microscopy and also Cochet-Bonnet in testing patients’ corneal sensitivity, there’s continual improvement in corneal sensitivity. And the confocal microscopy can show that there’s regrowth of corneal nerves, which, again, is something that we’ve always wondered. And if it does, how long does it actually continue? They showed recovery of the corneal sensitivity, corneal regeneration, corneal nerve growth for several months, because remember the study follows patients up to 8 months. Some of them are not eight months completely, pending when they finish their treatment course.

But this does suggest that topical Oxervate not only can maintain epithelial healing but also actively restore ocular surface homeostasis after it’s discontinuation. Because remember it’s only dosed six times a day for up to 8 weeks unless they need another course of treatment. But typically, it’s discontinued after one or two treatments in my experience. That means that we are actually going upstream far enough with the current treatment option, which to me is very exciting.