Topical Cenegermin for Pediatric Neurotrophic Keratopathy: A Review of the Literature and Systematic Review.

Abstract

Purpose: To evaluate current available evidence supporting the use of topical cenegermin (Oxervate, Dompe Farmaceutici, Milan, Italy) in pediatric neurotrophic keratopathy (pNK).

Methods: A literature search was conducted in PubMed CENTRAL, Google Scholar, EMBASE, the Register of Controlled Trials, and Ovid MEDLINE electronic databases of literature published up until May 2024 using the following terms singularly or in combination: "Oxervate," "cenegermin," "pediatric," "neurotrophic keratopathy," and "neurotrophic keratitis."

Results: Twelve studies (10 case reports, 2 case series) evaluating the outcomes of topical cenegermin in pNK were identified: 6 studies were conducted in the United States and 6 were conducted in Europe. In total, 26 eyes of 22 pediatric patients with a mean age of 6.75 ± 4.75 years (range: 0.3-18 years) were treated with topical cenegermin for pNK. A total of 20 of 26 eyes (76.9%) achieved an improvement of NK (19 eyes with complete resolution and 1 eye with partial improvement) that remained stable over 13.88 ± 8.2 months (range: 5-31 months) of follow-up. Of the remaining 6 eyes (23.1%), 3 eyes had no improvement, 1 eye had progressive melt and perforation during treatment, requiring a penetrating keratoplasty, and 2 eyes had recurrences with one eye requiring corneal neurotization and the other requiring amniotic membrane transplantation during treatment.

Conclusions: Topical cenegermin seems to be an effective option for treating pNK. However, the current literature is limited, and prospective controlled studies are needed to study its effects further.