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用尼麦角林治疗神经营养性角膜病变。

Treatment of neurotrophic keratopathy with nicergoline.

作者信息

Lee Young-Chun, Kim Su-Young

机构信息

Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Cornea. 2015 Mar;34(3):303-7. doi: 10.1097/ICO.0000000000000348.

Abstract

PURPOSE

The aim of this study was to determine the effect of nicergoline in patients with neurotrophic keratopathy.

METHODS

This is a prospective, noncomparative interventional study. The study included 27 eyes of 24 patients with neurotrophic keratopathy who were unresponsive to conventional therapy. Patients were treated with 10 mg of oral nicergoline twice daily for at least 2 weeks. Slit-lamp examination, photography, corneal fluorescein dye testing, Cochet-Bonnet corneal sensitivity, and best-corrected visual acuity tests were performed before and after treatment. Tear nerve growth factor levels were measured before and after treatment.

RESULTS

In 23 eyes (85%), epithelial defects healed completely between 7 and 30 days of treatment with nicergoline (mean, 15.6 ± 8.0 days). Epithelial defects persisted in 4 eyes (15%). The mean corneal sensitivity before and after treatment with nicergoline was 20.5 ± 8.5 and 30.2 ± 10.8 mm, respectively (P < 0.001). The best-corrected visual acuity (measured in units according to the logarithm of the minimum angle of resolution) was significantly improved from 1.1 ± 0.6 to 0.8 ± 0.6 (P < 0.001). The tear nerve growth factor levels were significantly higher ranging from 3.2 ± 0.3 to 6.2 ± 0.3 pg/mL (P < 0.001).

CONCLUSIONS

Treatment with nicergoline helps patients with neurotrophic keratopathy in whom conventional treatment has failed.

摘要

目的

本研究旨在确定尼麦角林对神经营养性角膜病变患者的疗效。

方法

这是一项前瞻性、非对比性干预研究。该研究纳入了24例对传统治疗无反应的神经营养性角膜病变患者的27只眼。患者每天口服10mg尼麦角林,每日两次,至少治疗2周。在治疗前后进行裂隙灯检查、摄影、角膜荧光素染色试验、Cochet-Bonnet角膜敏感性检查和最佳矫正视力测试。测量治疗前后泪液神经生长因子水平。

结果

在23只眼(85%)中,使用尼麦角林治疗7至30天之间上皮缺损完全愈合(平均,15.6±8.0天)。4只眼(15%)上皮缺损持续存在。使用尼麦角林治疗前后的平均角膜敏感性分别为20.5±8.5和30.2±10.8mm(P<0.001)。最佳矫正视力(根据最小分辨角对数以单位测量)从1.1±0.6显著提高到0.8±0.6(P<0.001)。泪液神经生长因子水平显著升高,范围从3.2±0.3至6.2±0.3pg/mL(P<0.001)。

结论

尼麦角林治疗有助于传统治疗失败的神经营养性角膜病变患者。

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