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199406, Санкт-Петербург, ул.Гаванская, д. 49, корп.2

ISSN 1999-6314

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«
Vol. 23, Art. 7 (pp. 119-135)    |    2022       
»

Clinical and immunological aspects of neurotrophic keratopathy
Maggie Ezugbaya, Inna A.Riks, Sergey Yu.Astakhov, Sanasar S.Papanyan, Vadim A. Turgel.

FSBEI HE Academician I.P. Pavlov First St Petersburg State Medical University of the Ministry of Healthcare of the Russia, Saint Petersburg, Russia
SBHI «Diagnostic center 7» of the Ministry of Healthcare of the Russia, Saint Petersburg, Russia



Brief summary

Neurotrophic keratopathy (NTK) is a neurodegenerative disease with an incidence of 5/10,000 of the population according to the literature. The clinical manifestations of NTC are diverse and require careful diagnosis. There are opinions about the role of neurogenic inflammation as the course of NTC.Aim: to evaluate the clinical and immunological manifestations of neurotrophic keratopathy at various stages of NTK. Material and methods. The study included 42 patients (42 eyes) aged 21 to 88 years with a diagnosis of neurotrophic keratopathy. The patients were divided into 3 main groups depending on the stage of the disease: group 1 - 6 patients with NTC stage I, group 2 - 13 patients with NTC stage II, group 3 - 23 patients with NTC stage III. The control group consisted of healthy volunteers, who were determined the state of the subbasal nerve plexus and the concentration of IL-1b and IL-8 in the lacrimal fluid. Results. In the first group, the BCVA median was 0.7; Norn test median 3.0; Schirmer's test median 11.0; OKT-PS 13. In the second group, BCVA 0.3; Norn test 2.0; Schirmer's test 5.5; OKT-PS 56.5. In group III, BCVA was 0.03; Norn test 2.0; Schirmer test 6.5. OKT-PS 157.0. Conclusion. As a result of the study, a decrease in the stability of the tear film and tear production was revealed in all major groups. The calculation of the corneal sensitivity reduction index, which reflects the severity of NTC, has been developed and put into practice. According to the morphological assessment of the subbasal nerve plexus, a statistically significant difference in changes in the main groups was obtained. There is a directly proportional relationship between the length and density of the subbasal nerve plexus and the severity of the neurotrophic process. With the progression of NTC, the length and density of the main nerve fibers of the cornea and their processes become significantly smaller. As a result of our study, a sufficiently high concentration of IL-1b and IL-8 in the lacrimal fluid in the affected eye was proved; and also revealed a statistically significant difference between the intact and diseased eye in the presence of these interleukins in the tear. Transparency of financial activities: none of the authors has a financial interest in the presented materials or methods. There is no conflict of interests.


Key words

cornea, neurotrophic keratopathy, corneal sensitivity, in vivo confocal microscopy, anterior segment optical coherence tomography, interleukins.





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