Nerve growth factor treatment in ocular surface diseases: potential application in refractive surgery
Alessandro Lambiase, Stefano Bonini
Department of Ophthalmology, University of Rome ?Campus Bio-Medico?
Summary: Nerve growth factor (NGF) is the prototype member of neurotrophin family which plays an essential role in the differentiation and survival of specific neurons localized in the peripheral and central nervous system. It was recently demonstrated that NGF plays a crucial role in the trophism and wound healing of the ocular surface. In vitro and in animal model NGF treatment promotes corneal healing and increases tear production. In humans, NGF treatment induces prompt corneal recovery associated with an improvement of corneal sensitivity in patients affected by neurotrophic keratitis. Excimer laser photokeratectomy is the most frequent surgical procedure performed for the correction of refractive errors. Despite the successful clinical outcomes, a few patients develop unsatisfactory visual acuity, regression of the achieved correction, corneal haze, poor contrast sensitivity, defect of wound healing, and a dry eye-like syndrome. Most of these complications have been related to the corneal nerve injury, due to the laser treatment, leading to a post-surgery neurotrophic disease. Preliminary data in animal models of refractive surgery show that NGF treatment induces a faster recovery of corneal epithelium after PRK associated with a decrease of keratocytes apoptosis and an increase of corneal reinnervation following LASIK. These data suggest a potential use of NGF eye drops to improve outcome of refractive surgery and to prevent possible complications.
Keywords: nerve growth factor, refractive surgery, wound healing.