Neurotrophic Keratitis: OD Winner

Case Information

A 95-year-old female presented to the clinic with decreased vision of her left eye. She did not have any pain or irritation. Multiple therapies were initiated over several weeks/months to help improve the size of the ulcer, but she had little resolution. Corneal PCR was also performed to ensure there was not an underlying infectious agent causing the corneal ulcer to worsen. She did not have full resolution until topical Cenegermin rhNGF was initiated.

Medical History:

DM Type II, hypertension, arthritis and anemia.

Concomitant Medications:

Amlodipine, glipizide, aspirin, buprenorphine transdermal patch, fluticasone propionate, furosemide, gabapentin, AREDs, ropinirole, HCl, and ondansetron.

Diagnosis:

Persistent corneal ulcer OS and neurotrophic keratitis OU.

Treatment:

She had minimal improvement with multiple bandage contact lenses, punctal plugs, frequent lubrication, and two amniotic membranes. Doxycycline 100mg BID was initiated during the treatment along with mild topical steroids and an antibiotic. The corneal ulcer did not start fully healing or improving until a 6-week course of topical Cenegermin rhNGF was added to her treatment plan.