Clinical Publications

TRITON

The Role of Hi-Tech Devices in Assessment of Corneal Healing in Patients with Neurotrophic Keratopathy

AUTHORS:

Inferrera L, Aragona E, Wylęgała A, Valastro A, Latino G, Postorino EI, Gargano R, Orzechowska-Wylęgała B, Wylęgała E, Roszkowska AM

PUBLICATION:

J. Clin. Med., 11(6), 2022. PMID: 35329927 DOI: 10.3390/jcm11061602

Study Purpose

The aim of this study is to analyze the morphological changes occurring during the healing of the corneal ulcers in patients with severe Neurotrophic Keratopathy (NK) treated with rh-NGF.

Overview

Study Design

Prospective, cross-sectional study

# of Eyes/
Patients

• 13 eyes in 13 patients with varying grades of NK

Study Device

Anterior segment module of the SS-OCT Triton (AS-OCT, DRI Triton, Topcon, Japan)
Keratograph 5M (OCULUS Optikgeräte GmbH, Wetzlar, Germany)
Laser Scanning Confocal microscope represented by Heidelberg retina tomograph (HRT) Rostock Cornea Module (Heidelberg Eng GmbH)

Outcome Measures

• Reduction of the area of the ulcer, and recovery of the corneal thickness at baseline, 4 and 8 wks post treatment

Results

At the eighth week, all corneal defects healed.
Median OCT levels for the three times were 333, 401, and 454 respectively for baseline, 4 weeks and 8 weeks.
Post hoc analysis showed statistically significant differences in all three follow-up times considered, with an increase in OCT levels (p = 0.015 first time vs. 4 weeks; p = 0.016 first time vs. 8 weeks and p = 0.016 4 weeks vs. 8 weeks). (Figure 2).
The confocal examination was performed only in three cooperating patients at baseline and in five subjects at 8 weeks at the end of treatment. The total absence of nerves was observed at baseline examination, whereas after 8weeks in four eyes the presence of sporadic fibers was detected.

IMOvifa reduced measurement time by

39%

FIGURE 2

FIGURE 2.

Variation of ulcer’s depth in a patient with post-herpetic NK treated with rh-NGF. The corneal thickness was calculated with OCT software at baseline: (i) 4 weeks, (ii) and 8 weeks (iii).Adapted from J. Clin. Med., 11(6), 2022. PMID: 35329927 DOI: 10.3390/jcm11061602

Conclusions

• AS-OCT was used to analyze the corneal thickness changes in the response to treatment with Cenegermin in patients with severe NK. The results showed a significant increase of the corneal thickness that permitted us to consider the importance of imaging in monitoring the healing process. • In the present study, we measured the extension and depth of the corneal defects, and we were able to provide a statistical assessment of the morphological changes occurring in the corneal tissue as a response to therapy. • Devices provided detailed information on the healing processes, improving our knowledge on corneal changes induced by therapy