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Corneal nerve regeneration in neurotrophic keratopathy following autologous plasma therapy
  1. Kavita Rao1,
  2. Christopher Leveque2,
  3. Stephen C Pflugfelder1
  1. 1Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
  2. 2Department of Pathology, Methodist Hospital, Houston, Texas, USA
  1. Correspondence to Dr Stephen C Pflugfelder, Ocular Surface Center, Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin NC205, Houston, TX 77030, USA; stevenp{at}


Aims To evaluate the effect of topical autologous plasma on nerve morphology in patients with neurotrophic keratopathy (NK) using the confocal microscope.

Methods Eleven eyes of six patients with neurotrophic keratopathy were evaluated for this study. Corneal fluorescein staining was done, and corneal sensitivity measurements were done with the Cochet–Bonnet and modified Belmonte gas aesthesiometers. The Heidelberg Retina Tomograph 2 Rostock Cornea Module laser scanning confocal microscope was used to image the corneal surface and subepithelial neural plexus. Four images at the level of the subepithelial nerve plexus in the central cornea were randomly selected for analysis of the corneal nerves. Topical autologous plasma was used six to eight times per day.

Results The best-corrected visual acuity improved significantly after plasma treatment in all patients (p=0.003). The mean corneal fluorescein staining score significantly decreased after treatment (p=0.0003). There was a significant increase in corneal sensitivity measured by Cochet–Bonnet (p<0.0001) and modified Belmonte (p=0.01) aesthesiometers. The mean number, length, width and density of subepithelial nerves increased significantly after plasma treatment (p=0.0002).

Conclusion In vivo confocal microscopy examination revealed preliminary evidence for improvement of corneal nerve findings suggesting efficacy of autologous plasma treatment in neurotrophic keratopathy.

  • Neurotrophic keratopathy
  • regenerated nerves
  • autologous plasma
  • confocal microscopy
  • ocular surface
  • cornea

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  • Funding NIH Grant EY11915 (SCP), an unrestricted grant from Research to Prevent Blindness, The Oshman Foundation, The William Stamps Farish Fund, The Hamill Foundation.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Baylor College of Medicine Institutional Review Board (IRB).

  • Provenance and peer review Not commissioned; externally peer reviewed.