Klinik und Diagnose der neurotrophen Keratopathie

Messmer, E. M. (2019): Klinik und Diagnose der neurotrophen Keratopathie. In: Ophthalmologe, Bd. 116, Nr. 2: S. 120-126

Abstract

BackgroundNeurotrophic keratopathy is characterized by corneal surface alterations, persistent corneal epithelial defects and/or corneal ulcerations associated with corneal sensory abnormalities. Due to the variable clinical picture neurotrophic keratopathy is often overlooked or diagnosed too late in the course of the disease.ObjectiveDiscussion of the clinical picture of neurotrophic keratopathy and recommendations for correct diagnosis.Material and methodsAnalysis of the existing literature and discussion of basic recent publications.ResultsNeurotrophic keratopathy is defined as adisease related to alterations in corneal nerves leading to impairment in sensory and trophic function with consequent breakdown of the corneal epithelium affecting health and integrity of the tear film, epithelium and stroma. It can occur with infections, autoimmune diseases, after trauma or ocular surgery, with intracranial neoplasia, in systemic diseases and genetic syndromes. It is classified into three stages: mild (epithelial changes without epithelial defects), moderate (epithelial defects) and severe (stromal involvement). The clinical hallmark is reduced or absent corneal sensation. Therefore, corneal sensitivity testing is essential in the diagnosis of neurotrophic keratopathy along with the patient history, clinical examination and diagnostic tests, such as vital stains and, if possible, in vivo confocal microscopy.ConclusionThe correct diagnosis and classification of neurotrophic keratopathy enable astage-adapted step-ladder therapeutic approach with subsequent reduction of progression and complications of the disease.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0941-293X
• Sprache: Deutsch