Topical treatment with nerve growth factor for neurotrophic keratitis.

OBJECTIVE: To evaluate the efficacy of nerve growth factor (NGF) in patients with neurotrophic keratitis. DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: Forty-five eyes of 43 consecutive patients with moderate (stage 2, n = 17) to severe (stage 3, n = 28) neurotrophic keratitis unresponsive to other nonsurgical therapies. METHODS: After a 10-day washout with preservative-free artificial tears, 45 eyes with neurotrophic keratitis received murine NGF (200 microg/ml) every 2 hours for 2 days followed by one drop six times daily until the ulcer healed. A maintenance dose of one drop NGF (100 microg/ml) was administered four times daily for the 2 weeks subsequent to ulcer healing. MAIN OUTCOME MEASURES: Size and depth of the ulcer or the epithelial defect, corneal sensitivity, best corrected visual acuity, side effects, and relapse of the disease in the follow-up period. RESULTS: All patients had a complete resolution of the persistent epithelial defect (with or without an ulcer) after 12 days to 6 weeks of treatment with NGF. Patients affected by both stages of the disease demonstrated both improved corneal sensitivity and visual acuity (P