Outcome of Cenegermin in the Treatment of Neurotrophic Keratopathy

Purpose: To evaluate the efficacy of cenegermin 0.002% in neurotrophic keratopathy (NK). Methods: This is a single-center retrospective case series. Data including demographic information, clinical characteristics, and staging of NK at baseline and 8 weeks were collected and analyzed. The primary outcome was improvement in NK 8 weeks after treatment, defined as a reduction in corneal epithelial defect size, or decreased corneal staining score in those without epithelial defect. Secondary outcomes include recurrence and the need for additional intervention. Results: Fifty-two eyes of 49 patients (mean age 66.0 ± 18.0 years) were included. The mean follow-up was 26.0 ± 16.0 (range 4–51) months. Twenty eyes (38.5%) were classified as Mackie stage 1, 24 (46.2%) as stage 2, and 8 (15.4%) as stage 3 NK. Overall, 67.3% of patients showed improvement by week 8, with resolution of corneal epithelial defect in 62.5% of patients with stage 2 and 3 NK, and a significant decrease in staining score among those with stage 1 disease (2.57 ± 1.07–2.15 ± 1.27, P = 0.002). Multiple logistic regression showed a significant association between Mackie staging and treatment success with cenegermin (OR: 4.79, 95% CI: 1.13–20.26, P = 0.03). Recurrence of NK after cenegermin treatment was observed in 37.5% of eyes within 4 months of follow-up. In patients who received a second course subsequently, 58.3% showed treatment success. Conclusions: Cenegermin is an effective treatment of NK in the clinical setting, although a notable proportion of patients experience disease recurrence subsequently. Mackie staging is a significant prognostic factor for treatment success.