Efficacy of plasma rich in growth factors (PRGF) in stage 1 neurotrophic keratitis

Abstract

Background/Aims: Neurotrophic keratitis (NK) is a neurodegenerative disease that can lead to corneal hypoesthesia, decreased tear production, and epitheliopathy. Based on the severity of ocular surface damage, NK is classi ed into 3 stages. Stage 1 NK is characterized by super cial punctate keratopathy, tear lm instability, and reduced corneal sensation. The therapeutic e cacy of PRGF eye drops for NK stages 2 and 3 has been previously reported. In this study, we evaluated the e cacy and safety of autologous PRGF eye drops in improving corneal sensitivity and other ocular surface clinical signs in patients with stage 1 NK. Methods: Retrospective chart reviewResults: 26 eyes of 15 stage 1 NK patients (seven males, eight females), aged 76.3 ± 12.1 years, were included in the study. The mean treatment duration was 2 ± 1.8 months. With PRGF treatment, corneal sensitivity increased from 2.8 to 4.5 cm in 53.8% (14/26) (p < 0.01), TBUT increased from 3.6 to 5.0 s in 69.2% (18/26) (p < 0.01), and Schirmer score increased from 13.7 to 16.8 mm in 80.7% (21/26) of treated eyes (p < 0.01). Similarly, an improvement in corneal staining (punctate epithelial erosions) and MMP-9 levels was seen in 80.7% (n = 21) and 65.4% (n = 17) of treated eyes, respectively. BCVA improvement was seen in 26.9% of treated eyes (n = 7).Conclusions:This study demonstrates the effective role of PRGF therapy in recovering corneal sensation and tear lm function and in the healing of corneal erosions in stage 1 NK patients.