Clinical review for general practice

Neurotrophic keratitis (NK) is a severe corneal disease resulting from the innervation disorder and leading to the development of persistent corneal epithelial defects. One NK cause is represented by the infections caused by herpes simplex viruses 1 and 2, herpesviruses 3 and 6, cytomegalovirus, Epstein–Barr virus in the outcome of acute inflammation. To implement the set of measures on treatment of herpes NK, it is necessary to previously conduct adequate treatment of herpesvirus infection with systemic and topical drugs and, after receiving confirmation of the infection control measure efficacy, proceed to immunosuppressive and reparative therapy. When the efficacy of the available reparative therapy conducted for at least 3 months is insufficient, and the non-healing epithelial-stromal defect of the epithelium together with the marked decrease or loss of sensitivity of the cornea persist for a long time, pathogenetic therapy with Cenegermin (recombinant human nerve growth factor) and the use of other methods (such as tarsorrhaphy, amniotic membrane grafts, keratoplasty, neurotization) for prevention of the corneal lysis and perforation can be considered. 

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