Alex Young , 2025-05-19 18:49:00
Key takeaways:
- Neuropathy and inflammation work together to drive common manifestations of corneal disease.
- Early intervention can help.
LOS ANGELES — Ophthalmologists should act early to prevent a “vicious” cycle of neuropathy and inflammation in corneal disease, according to a speaker at the American Society of Cataract and Refractive Surgery meeting.
In this year’s Richard L. Lindstrom, MD, Lecture, Reza Dana, MD, MPH, MSc, said neural dysregulation and inflammation “co-conspire” to induce ocular surface pathology.
Reza Dana, MD, MPH, MSc, (center), receives the Lindstrom Medal from Richard L. Lindstrom, MD, (right) and Marjan Farid, MD.
“One amplifies the other, and they lead to corneal disease,” Dana said. “The most common manifestations of that disorder — pain, redness, dry eye, corneal neovascularization or angiogenesis, and even endothelial disease — are linked, as you’ll see, with neuropathy and inflammation.”
Dana said the cornea has a dense network of nerves as well as immune cells, and immune-based epitheliopathy, seen in common conditions such as dry eye disease and uncommon conditions such as Stevens-Johnson syndrome, is closely related to neuropathy.
He described a cycle of inflammation, neuropathy and epithelial disease, as well as the mechanisms that lead to typical corneal pathologies, including pain and redness, angiogenesis and endothelial disease.
In patients with any manifestation of epithelial disease, Dana suggested providing lubricants and ocular surface optimization as soon as possible. For patients with any manifestation of neuropathy, he said to used biologics, including recombinant nerve growth factor and autologous serum.
For inflammation, he urged judicious use of anti-inflammatories, specifically “soft” steroids rather than potent corticosteroids.
“The implication for all of you, whether you’re a cornea, cataract or any ophthalmologist, is that when you see patients early on that have any sign of neuropathy or epithelial disease or inflammation, the key point is to prevent this vicious cycle from taking hold,” Dana said. “You want to intervene early.”
Sources/Disclosures
Collapse
Dana R. The Lindstrom Lecture. Presented at: American Society of Cataract and Refractive Surgery meeting; April 25-28, 2025; Los Angeles.
Disclosures:
Dana reports no relevant financial disclosures.
