NEW YORK (Reuters) -- Eyedrops containing nerve growth factor have restored the vision of patients suffering from corneal neurotrophic ulcers, which usually lead to a loss of sight, researchers report.
"All ocular symptoms disappeared once the corneal ulcer was completely healed," say Italian investigators led by Dr. Alessandro Lambiase of the University of Rome Tor Vergata, and the National Research Council, both in Rome. The study appears Thursday in The New England Journal of Medicine.
Corneal neurotrophic ulcer is a relatively rare but devastating ophthalmologic condition involving a gradual degradation of the corneal nerves. More than half of all cases occur as a result of infection with the herpes simplex virus, while other cases seem to be triggered by the improper use of contact lenses, complications from eye surgery, injury, or illnesses such as diabetes or multiple sclerosis. Corneal neurotrophic ulcers usually lead to a gradual loss of vision in the affected eye. Until now, experts have found no effective treatment for the disease.
Lambiase and his colleagues focused their research on a recently discovered compound called nerve growth factor, which seems to stimulate healing and regrowth in nerve pathways.
They administered eyedrops containing nerve growth factor into the affected eyes of 12 individuals suffering from corneal neurotrophic ulcers. Patients received the eyedrops every 2 hours during waking hours over the course of a few weeks.
The result? "All patients had complete resolution of the corneal ulcer after 10 days to 6 weeks of treatment with nerve growth factor, at which time the dosage was reduced for 2 weeks and then discontinued," according to the study authors. They say "the healing process began 2 days after initial treatment in three patients and within 2 weeks in the other patients."
Dissimilarities between illness types or patient age seemed to have little impact on healing rates, and there were no adverse treatment side effects. Vision progressively improved with time, and any corneal scarring gradually disappeared.
In an accompanying editorial, Drs. Ronald Smith and Alfredo Sadun of the University of Southern California, Los Angeles, point out that the Italian results may represent the mere tip of the iceberg when it comes to the potential therapeutic uses of nerve growth factor. They write: "Much as the cornea has been regarded as the window to the eye, the brain, and even the soul, so it may now prove to be a window to the trophic (healing) effects of nerve growth factor."
SOURCE: The New England Journal of Medicine (1998;338:1174-1180, 1222-1223)
