Persistent epithelial defects due to neurotrophic keratopathy treated with a substance p-derived peptide and insulin-like growth factor 1.
OBJECTIVE
The loss of corneal sensation results in the development of persistent corneal epithelial defects. The combination of a substance P-derived peptide, phenylalanine -glycine-leucine-methionine (FGLM)-amide, and insulin-like growth factor 1 (IGF-1) stimulates corneal epithelial migration in vitro and corneal epithelial wound closure in vivo. The clinical efficacy of eye drops containing FGLM-amide and IGF-1 for the treatment of persistent epithelial defects in individuals with neurotrophic keratopathy was examined in a prospective open study.


METHODS
Eleven patients with persistent corneal epithelial defects associated with neurotrophic keratopathy were treated for up to 28 days by the administration of eye drops containing FGLM-amide and IGF-1. The course of epithelial healing was monitored by slit-lamp examination, and visual acuity was measured before and after treatment.


RESULTS
Complete epithelial resurfacing was achieved in eight of the nine (89%) cases of persistent epithelial defects in the nine patients who received the full course of treatment. Epithelial defects had completely resurfaced in two of nine (22%) and five of nine (56%) cases within 1 and 2 weeks, respectively, after treatment initiation. No adverse effects of treatment were observed in any of the 11 patients.


CONCLUSIONS
Eye drops containing FGLM-amide and IGF-1 induced the rapid resurfacing of persistent epithelial defects in individuals with neurotrophic keratopathy.
D000328:Adult; D000368:Aged; D003315:Cornea / Q000294:innervation; D004359:Drug Therapy, Combination; D019573:Epithelium, Corneal / Q000187:drug effects*; D005260:Female; D015590:Fluorophotometry; D005500:Follow-Up Studies; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000008:administration & dosage*; D007634:Keratitis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000008:administration & dosage*; D009883:Ophthalmic Solutions / Q000008:administration & dosage*; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014945:Wound Healing / Q000187:drug effects*
D009842:Oligopeptides; D009883:Ophthalmic Solutions; C112946:phenylalanyl-glycyl-leucyl-methioninamide; D007334:Insulin-Like Growth Factor I