Roth Mathias, Dierse Sebastian, Alder Jan, Holtmann Christoph, Geerling Gerd
Department of Ophthalmology, Heinrich-Heine University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
Graefes Arch Clin Exp Ophthalmol. 2022 Jun;260(6):1961-1973. doi: 10.1007/s00417-021-05535-z. Epub 2022 Jan 6.
Neurotrophic keratopathy (NK) is an orphan disease, with an estimated prevalence of 1-5/10,000. No data regarding the incidence exists. The primary aim was to evaluate incidence and prevalence of NK at a tertiary referral center in Germany, and the secondary aim was to analyze demographic parameters, etiology, and clinical features and therapeutic outcomes.
All patients treated for NK with serum eye drops (SED), amnionic membrane transplantation (AMT), or penetrating keratoplasty (PK) in 2013-2017 were identified. Age, sex, etiology of NK, visual acuity, disease stage, treatment, and visual acuity were analyzed. Incidence and prevalence of NK in our hospital and the overall population of the city were calculated.
In 63 eyes of 60 patients (56.7% male; 68 ± 16 years), the most common underlying diseases were herpetic infections (23.8%), neurological causes (19%), and diabetes mellitus (14.3%). The annual incidence of NK in our tertiary referral center ranges between 5/10,000 and 3/10,000, the prevalence between 9/10,00 and 22/10,000. In all patients treated with corneal ulcers, the prevalence was up to 27% (2706/10,000). The incidence in the overall population is estimated at 0.1-0.3/10,000, the prevalence at 0.2-0.5/10,000 to 0.5/10,000.
Based on our assessment, the prevalence of NK in the overall population is lower than estimated before. However, in patients with corneal ulcers, the percentage of NK is comparably high. The disease may still be underdiagnosed due to the variety of underlying disorders and unknown comorbidities. Thus, in cases of therapy-refractive superficial keratopathy or ulcerations, NK should be considered more frequently.
神经营养性角膜病变（NK）是一种罕见病，估计患病率为1-5/10000。目前尚无关于发病率的数据。主要目的是评估德国一家三级转诊中心NK的发病率和患病率，次要目的是分析人口统计学参数、病因、临床特征及治疗效果。
确定2013年至2017年期间所有接受血清眼药水（SED）、羊膜移植（AMT）或穿透性角膜移植术（PK）治疗NK的患者。分析患者的年龄、性别、NK病因、视力、疾病阶段、治疗方法及视力情况。计算我院及该市总人口中NK的发病率和患病率。
60例患者的63只眼（男性占56.7%；年龄68±16岁），最常见的基础疾病为疱疹感染（23.8%）、神经病因（19%）和糖尿病（14.3%）。我院三级转诊中心NK的年发病率在5/10000至3/10000之间，患病率在9/10000至22/10000之间。在所有接受角膜溃疡治疗的患者中，患病率高达27%（2706/10000）。总体人群中的发病率估计为0.1-0.3/10000，患病率为0.2-0.5/10000至0.5/10000。
根据我们的评估，总体人群中NK的患病率低于之前的估计。然而，在角膜溃疡患者中，NK的比例相对较高。由于潜在疾病种类繁多且合并症不明，该病可能仍未得到充分诊断。因此，在治疗屈光性浅层角膜病变或溃疡时，应更频繁地考虑NK。
