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羊膜移植治疗干眼症和神经营养性角膜炎。

Amniotic membrane transplantation for managing dry eye and neurotrophic keratitis.

作者信息

Mead Olivia G, Tighe Sean, Tseng Scheffer C G

机构信息

R&D Department, TissueTech Inc., Miami, FL, USA.

Department of Ophthalmology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.

出版信息

Taiwan J Ophthalmol. 2020 Mar 4;10(1):13-21. doi: 10.4103/tjo.tjo_5_20. eCollection 2020 Jan-Mar.

Abstract

Neurotrophic keratitis (NK), a degenerative disease caused by damage to the trigeminal nerve, abolishes both tearing and blinking reflexes, thus causing the most severe forms of dry eye disease (DED). Conversely, the increasing severity of DED also leads to progressive loss of corneal nerve density, potentially resulting in NK. Both diseases manifest the same spectrum of corneal pathologies including inflammation and corneal epithelial keratitis, which can progress into vision-threatening epithelial defect and stromal ulceration. This review summarizes the current literature regarding outcomes following sutured and sutureless cryopreserved amniotic membrane (AM) in treating DED as well as epithelial defects and corneal ulcers due to underlying NK. These studies collectively support the safety and effectiveness of cryopreserved AM in restoring corneal epithelial health, improving visual acuity in eyes with NK and DED, and alleviating symptomatic DED. Future randomized controlled trials are warranted to validate the above findings and determine whether such clinical efficacy lies in promoting corneal nerve regeneration.

摘要

神经营养性角膜炎(NK)是一种由三叉神经损伤引起的退行性疾病,它会消除流泪和眨眼反射,从而导致最严重形式的干眼病(DED)。相反,DED严重程度的增加也会导致角膜神经密度逐渐丧失,有可能导致NK。这两种疾病都表现出相同范围的角膜病变,包括炎症和角膜上皮角膜炎,可进展为威胁视力的上皮缺损和基质溃疡。本综述总结了当前关于缝合和无缝合冷冻保存羊膜(AM)治疗DED以及因潜在NK导致的上皮缺损和角膜溃疡的研究结果。这些研究共同支持了冷冻保存羊膜在恢复角膜上皮健康、提高NK和DED患者视力以及缓解症状性DED方面的安全性和有效性。未来有必要进行随机对照试验来验证上述发现,并确定这种临床疗效是否在于促进角膜神经再生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed88/7158925/92c72182a009/TJO-10-13-g001.jpg

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