Posters

Successful treatment of a neurotrophic corneal ulcer after acanthamoeba keratitis using recombinant human nerve growth factor (rhNGF)

Poster Details

First Author: A.Almoallem GERMANY

Co Author(s): F. Luciani                    

Abstract Details

Purpose:

To report a case of favorable resolution of a neurotrophic corneal ulcer secondary to acanthamoeba keratitis with recombinant human nerve growth factor (rhNGF)

Setting:

University Hospital of Giessen and Marburg- Giermany

Methods:

Patient suffered from severe visual loss and pain on his right eye 2 days after wearing contact lenses he was referred to cornea service of our department.We saw a central corneal ulcer associated with severe inflammation and hypopyon,We promptly started treatment with chlorhexidine gluconate eye drops 6 times daily, propamidine isethionate eye drop 6 times daily and voriconazole eye drops 8 times daily.The hypopyon resolved and the amoeba infection was controlled but a neurotrophic corneal ulcer developed and persisted with all conventional treatments we started treatment with rhNGF 6 times daily for 8 weeks.Corneal sensitivity was tested before and after.

Results:

After 8 weeks of rhNGF treatment visual acuity improved from light perception to counting fingers in 1 m. The round corneal ulcer "10 mm in diameter" had completely resolved. Corneal sensitivity was abolished before treatment and reestablished after 4 weeks. The patient went through a short phase of severe pain indicating reinnervation of the cornea.

Conclusions:

Treatment with rhNGF was safe and effective  in a case of neurotrophic corneal ulcer secondary to acanthamoeba to resolve corneal epithelial defect and restore corneal sensitivity. Adjuvant therapy with topical hydrocortisone to control inflammation and pain management was crucial to maintain treatment compliance.

Financial Disclosure:

None