Treatment of neurotrophic keratopathy with nicergoline

Cornea. 2015 Mar;34(3):303-7. doi: 10.1097/ICO.0000000000000348.

Abstract

Purpose: The aim of this study was to determine the effect of nicergoline in patients with neurotrophic keratopathy.

Methods: This is a prospective, noncomparative interventional study. The study included 27 eyes of 24 patients with neurotrophic keratopathy who were unresponsive to conventional therapy. Patients were treated with 10 mg of oral nicergoline twice daily for at least 2 weeks. Slit-lamp examination, photography, corneal fluorescein dye testing, Cochet-Bonnet corneal sensitivity, and best-corrected visual acuity tests were performed before and after treatment. Tear nerve growth factor levels were measured before and after treatment.

Results: In 23 eyes (85%), epithelial defects healed completely between 7 and 30 days of treatment with nicergoline (mean, 15.6 ± 8.0 days). Epithelial defects persisted in 4 eyes (15%). The mean corneal sensitivity before and after treatment with nicergoline was 20.5 ± 8.5 and 30.2 ± 10.8 mm, respectively (P < 0.001). The best-corrected visual acuity (measured in units according to the logarithm of the minimum angle of resolution) was significantly improved from 1.1 ± 0.6 to 0.8 ± 0.6 (P < 0.001). The tear nerve growth factor levels were significantly higher ranging from 3.2 ± 0.3 to 6.2 ± 0.3 pg/mL (P < 0.001).

Conclusions: Treatment with nicergoline helps patients with neurotrophic keratopathy in whom conventional treatment has failed.

MeSH terms

  • Adrenergic alpha-Antagonists / therapeutic use*
  • Adult
  • Aged
  • Aged, 80 and over
  • Corneal Ulcer / drug therapy*
  • Corneal Ulcer / metabolism
  • Corneal Ulcer / physiopathology
  • Drug Administration Schedule
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nerve Growth Factor / metabolism
  • Nicergoline / therapeutic use*
  • Prospective Studies
  • Tears / metabolism
  • Visual Acuity / physiology

Substances

  • Adrenergic alpha-Antagonists
  • Nerve Growth Factor
  • Nicergoline