Neurotrophic Keratopathy after Trigeminal Nerve Block for Treatment of Postherpetic Neuralgia
Purpose. To report a case of persistent corneal epithelial defect that had occurred after a trigeminal nerve block. Case Presentation. A 75-year-old female had suffered from postherpetic neuralgia for 8 years. She underwent Gasserian ganglion block surgery and noticed declining visual acuity in the...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Case Reports in Ophthalmological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2018/6815407 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832559526340984832 |
|---|---|
| author | Aya Kodama-Takahashi Koji Sugioka Tomoko Sato Koichi Nishida Keiichi Aomatsu Masahiko Fukuda Yoshikazu Shimomura |
| author_facet | Aya Kodama-Takahashi Koji Sugioka Tomoko Sato Koichi Nishida Keiichi Aomatsu Masahiko Fukuda Yoshikazu Shimomura |
| author_sort | Aya Kodama-Takahashi |
| collection | DOAJ |
| description | Purpose. To report a case of persistent corneal epithelial defect that had occurred after a trigeminal nerve block. Case Presentation. A 75-year-old female had suffered from postherpetic neuralgia for 8 years. She underwent Gasserian ganglion block surgery and noticed declining visual acuity in the right eye on the following day. She presented with severe hyperemia and corneal epithelial defects in the right eye and experienced remarkable reduction of sensitivity in the right cornea. She was diagnosed with neurotrophic keratopathy. Ofloxacin eye ointment and rebamipide ophthalmic suspension ameliorated the corneal epithelial defects but superficial punctate keratopathy, corneal superficial neovascularization, and Descemet’s fold persisted. Although the epithelial defects occasionally recurred, the corneal sensation and epithelial defects, Descemet’s fold, and corneal superficial neovascularization all improved around 5 months after trigeminal nerve block. The HRT II Rostock Cornea Module (RCM) could not detect any corneal subbasal nerve fibers at postoperative 4 months; however, it could detect them at postoperative 6 months. Conclusions. As the nerve block effect wore off, the corneal subbasal nerve fibers slowly regenerated. As the corneal sensation improved, the corneal epithelial defects and superficial neovascularization also improved. The HRT II RCM appeared useful for observing loss and regeneration of the corneal subbasal nerve fibers. |
| format | Article |
| id | doaj-art-ed0ecbe4dc404f74a3c306cb60b6284f |
| institution | Kabale University |
| issn | 2090-6722 2090-6730 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Ophthalmological Medicine |
| spelling | doaj-art-ed0ecbe4dc404f74a3c306cb60b6284f2025-02-03T01:29:54ZengWileyCase Reports in Ophthalmological Medicine2090-67222090-67302018-01-01201810.1155/2018/68154076815407Neurotrophic Keratopathy after Trigeminal Nerve Block for Treatment of Postherpetic NeuralgiaAya Kodama-Takahashi0Koji Sugioka1Tomoko Sato2Koichi Nishida3Keiichi Aomatsu4Masahiko Fukuda5Yoshikazu Shimomura6Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama City, JapanDepartment of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama City, JapanDepartment of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama City, JapanDepartment of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama City, JapanDepartment of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama City, JapanDepartment of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama City, JapanDepartment of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama City, JapanPurpose. To report a case of persistent corneal epithelial defect that had occurred after a trigeminal nerve block. Case Presentation. A 75-year-old female had suffered from postherpetic neuralgia for 8 years. She underwent Gasserian ganglion block surgery and noticed declining visual acuity in the right eye on the following day. She presented with severe hyperemia and corneal epithelial defects in the right eye and experienced remarkable reduction of sensitivity in the right cornea. She was diagnosed with neurotrophic keratopathy. Ofloxacin eye ointment and rebamipide ophthalmic suspension ameliorated the corneal epithelial defects but superficial punctate keratopathy, corneal superficial neovascularization, and Descemet’s fold persisted. Although the epithelial defects occasionally recurred, the corneal sensation and epithelial defects, Descemet’s fold, and corneal superficial neovascularization all improved around 5 months after trigeminal nerve block. The HRT II Rostock Cornea Module (RCM) could not detect any corneal subbasal nerve fibers at postoperative 4 months; however, it could detect them at postoperative 6 months. Conclusions. As the nerve block effect wore off, the corneal subbasal nerve fibers slowly regenerated. As the corneal sensation improved, the corneal epithelial defects and superficial neovascularization also improved. The HRT II RCM appeared useful for observing loss and regeneration of the corneal subbasal nerve fibers.http://dx.doi.org/10.1155/2018/6815407 |
| spellingShingle | Aya Kodama-Takahashi Koji Sugioka Tomoko Sato Koichi Nishida Keiichi Aomatsu Masahiko Fukuda Yoshikazu Shimomura Neurotrophic Keratopathy after Trigeminal Nerve Block for Treatment of Postherpetic Neuralgia Case Reports in Ophthalmological Medicine |
| title | Neurotrophic Keratopathy after Trigeminal Nerve Block for Treatment of Postherpetic Neuralgia |
| title_full | Neurotrophic Keratopathy after Trigeminal Nerve Block for Treatment of Postherpetic Neuralgia |
| title_fullStr | Neurotrophic Keratopathy after Trigeminal Nerve Block for Treatment of Postherpetic Neuralgia |
| title_full_unstemmed | Neurotrophic Keratopathy after Trigeminal Nerve Block for Treatment of Postherpetic Neuralgia |
| title_short | Neurotrophic Keratopathy after Trigeminal Nerve Block for Treatment of Postherpetic Neuralgia |
| title_sort | neurotrophic keratopathy after trigeminal nerve block for treatment of postherpetic neuralgia |
| url | http://dx.doi.org/10.1155/2018/6815407 |
| work_keys_str_mv | AT ayakodamatakahashi neurotrophickeratopathyaftertrigeminalnerveblockfortreatmentofpostherpeticneuralgia AT kojisugioka neurotrophickeratopathyaftertrigeminalnerveblockfortreatmentofpostherpeticneuralgia AT tomokosato neurotrophickeratopathyaftertrigeminalnerveblockfortreatmentofpostherpeticneuralgia AT koichinishida neurotrophickeratopathyaftertrigeminalnerveblockfortreatmentofpostherpeticneuralgia AT keiichiaomatsu neurotrophickeratopathyaftertrigeminalnerveblockfortreatmentofpostherpeticneuralgia AT masahikofukuda neurotrophickeratopathyaftertrigeminalnerveblockfortreatmentofpostherpeticneuralgia AT yoshikazushimomura neurotrophickeratopathyaftertrigeminalnerveblockfortreatmentofpostherpeticneuralgia |