Neurotrophic keratopathy: current concepts of the mechanisms of development and prospects for treatment
DOI: 10.32364/2311-7729-2026-26-3-10
Neurotrophic keratopathy: current concepts of the mechanisms of development and prospects for treatment
A.V. Surov1,2, O.I. Lebedev1, D.E. Bolgova3
1 Omsk State Medical University, Omsk, Russian Federation
2 V.P. Vykhodtsev Clinical Ophthalmological Hospital, Omsk, Russian Federation
3 Center for Medical Prevention and Correction of Vision Anomalies, Omsk, Russian Federation
Neurotrophic keratopathy (NK), also referred to as neurotrophic keratitis, is a rare degenerative corneal disease characterized by impaired corneal sensory innervation, resulting in epithelial defects with or without stromal ulceration (melting), accompanied by reduced or absent corneal sensitivity. The most common cause of NK is previous herpetic keratitis; however, any condition that disrupts the integrity or normal function of the corneal nerves may lead to the development of this disorder. The pathogenesis of NK is associated with dysfunction of the corneal nerves originating from the first (ophthalmic) branch of the trigeminal nerve, leading to impaired corneal epithelial homeostasis and the formation of non-healing erosions. NK is classified according to the severity of corneal damage: stage 1 — epitheliopathy, stage 2 — persistent corneal erosion, and stage 3 — corneal ulcer and its complications. A variety of conservative and surgical treatment strategies are currently available to stabilize disease progression, improve patient outcomes, and prevent vision loss. This review provides a comprehensive overview of NK, summarizing current knowledge on its pathogenesis, diagnosis, therapeutic approaches, and emerging treatment modalities that may offer improved efficacy and safety compared with conventional management.
Keywords: neurotrophic keratitis, neurotrophic keratopathy, corneal nerves, corneal ulcer, corneal neurotization.
For citation: Surov A.V., Lebedev O.I., Bolgova D.E. Neurotrophic keratopathy: current concepts of the mechanisms of development and prospects for treatment. Russian Journal of Clinical Ophthalmology. 2026;26(3):262–267 (in Russ.). DOI: 10.32364/2311-7729-2026-26-3-10
ABOUT THE AUTHORS:
Aleksandr V. Surov — C. Sc. (Med.), Associate Professor, Head of the Department of Ophthalmology, Omsk State Medical University; 12, Lenin str., Omsk, 644099, Russian Federation; Head of Microsurgical Department No. 2, V.P. Vykhodtsev Clinical Ophthalmological Hospital; 60, Lermontov str., Omsk, 644024, Russian Federation; ORCID iD 0000-0001-9185-1529
Oleg I. Lebedev — Dr. Sc. (Med.), Professor of the Department of Ophthalmology, Omsk State Medical University; 12, Lenin str., Omsk, 644099, Russian Federation; ORCID iD 0000-0001-6678-2947
Darya E. Bolgova — ophthalmologist, Center for Medical Prevention and Correction of Vision Anomalies; 20, Lermontov str., Omsk, 644024, Russian Federation; ORCID iD 0009-0005-8121-0062
Contact information: Aleksandr V. Surov, e-mail: abc55.79@mail.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 25.08.2025.
Revised 15.09.2025.
Accepted 09.10.2025.
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