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Article

High Molecular Weight Hyaluronan Promotes Corneal Nerve Growth in Severe Dry Eyes

1
Department of Clininical Neuroscience, St. Eriks Eye Hospital, Karolinska Institutet, 11282 Stockholm, Sweden
2
Department of Ophthalmology, University Medical Center Rostock, 18057 Rostock, Germany
3
Quinze-Vingts National Eye Hospital & Vision Institute, 75571 Paris, France
4
Department of Ophthalmology, Marmara University School of Medicine, 34899 Istanbul, Turkey
5
Department of Ophthalmology, Saarland University Medical Center, 66421 Homburg/Saar, Germany
6
Department of Ophthalmology & Department of Experimental Ophthalmology and Glaucoma Research, University Clinic Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
7
Institute of Anatomy, Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
8
Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
9
CORONIS GmbH, 81241 Munich, Germany
*
Author to whom correspondence should be addressed.
Contributed equally.
J. Clin. Med. 2020, 9(12), 3799; https://doi.org/10.3390/jcm9123799
Received: 5 October 2020 / Revised: 19 November 2020 / Accepted: 22 November 2020 / Published: 24 November 2020
(This article belongs to the Special Issue Cutting-Edge Topics in Dry Eye Disease)
The purpose of this study was to investigate the effect of high molecular weight hyaluronan (HMWHA) eye drops on subbasal corneal nerves in patients suffering from severe dry eye disease (DED) and to evaluate the damage of subbasal corneal nerves associated with severe DED. Designed as an international, multicenter study, 16 patients with symptoms of at least an Ocular Surface Disease Index (OSDI) score of 33, and corneal fluorescein staining (CFS) of at least Oxford grade 3, were included and randomized into two study arms. The control group continued to use their individual optimum artificial tears over the study period of eight weeks; in the verum group, the artificial tears were substituted by eye drops containing 0.15% HMWHA. At the baseline visit, and after eight weeks, the subbasal nerve plexus of 16 patients were assessed by confocal laser scanning microscopy (CSLM). The images were submitted to a masked reading center for evaluation. Results showed a significant increase of total nerve fiber lengths (CNFL) in the HMWHA group (p = 0.030) when compared to the control group, where the total subbasal CNFL did not significantly change from baseline to week 8. We concluded that in severe DED patients, HMWHA from topically applied eye drops could cross the epithelial barrier and reach the subbasal nerve plexus, where it exercised a trophic effect. View Full-Text
Keywords: dry eye disease; severe keratitis; diabetes; neuropathic keratopathy; neuropathy; nerve growth; neurotrophic dry eye disease; severe keratitis; diabetes; neuropathic keratopathy; neuropathy; nerve growth; neurotrophic
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MDPI and ACS Style

van Setten, G.-B.; Stachs, O.; Dupas, B.; Turhan, S.A.; Seitz, B.; Reitsamer, H.; Winter, K.; Horwath-Winter, J.; Guthoff, R.F.; Müller-Lierheim, W.G.K. High Molecular Weight Hyaluronan Promotes Corneal Nerve Growth in Severe Dry Eyes. J. Clin. Med. 2020, 9, 3799. https://doi.org/10.3390/jcm9123799

AMA Style

van Setten G-B, Stachs O, Dupas B, Turhan SA, Seitz B, Reitsamer H, Winter K, Horwath-Winter J, Guthoff RF, Müller-Lierheim WGK. High Molecular Weight Hyaluronan Promotes Corneal Nerve Growth in Severe Dry Eyes. Journal of Clinical Medicine. 2020; 9(12):3799. https://doi.org/10.3390/jcm9123799

Chicago/Turabian Style

van Setten, Gysbert-Botho, Oliver Stachs, Bénédicte Dupas, Semra A. Turhan, Berthold Seitz, Herbert Reitsamer, Karsten Winter, Jutta Horwath-Winter, Rudolf F. Guthoff, and Wolfgang G.K. Müller-Lierheim 2020. "High Molecular Weight Hyaluronan Promotes Corneal Nerve Growth in Severe Dry Eyes" Journal of Clinical Medicine 9, no. 12: 3799. https://doi.org/10.3390/jcm9123799

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