Following FDA approval of cenegermin, referrals for neurotrophic keratitis have increased

Pedram Hamrah, MD, of the University of South Florida, spoke with Optometry 360 at the AAO Annual Meeting 2025 about how the 2018 FDA approval of cenegermin for neurotrophic keratitis has increased awareness of the condition.

Pedram Hamrah, MD:

Hi, I am Pedram Hamrah. I am a professor and vice chair of ophthalmology at University of South Florida in Tampa. I’m also the co-director of the Cornea Service and the director of the clinical and translational clinical research there. I’m going to talk about one of our recent studies that we presenting at the Academy.

The background is that, we wanted to see whether, since the introduction of recombinant human nerve growth factor, things have changed in the landscape of neurotrophic keratopathy patients. Whether this has any impact on the incidence and prevalence of these cases and whether the etiologies have changed. We have found that, since approval of recombinant human nerve growth back in 2018 and the introduction commercially in 2019, things have changed. What we had done, designed the study was, is to look at over 200 patients with neurotrophic keratopathy in stages 1, 2, and 3, and to look at the number of patients we see per year, to the severity of these patients we see by year and also the etiological changes we see, whether that has any changes overall.

There were several major findings that we had. One was that, we have found out that the total number of patients have increased because there was an increased awareness to NK. However, we also found that the number of stage 2 and 3 patients have decreased because there’s not a very commercially available drug that is on the market. This has resulted in a decrease of NK stage 2 and 3 patients, and in an increase of NK stage 1 patients overall.

A couple of things we also found is that, overall the severity of patients at the time of presentation to the clinics have decreased. There’s less larger ulcers, there’s smaller ulcers, and there’s also less staining in these cases. The corneal sensation has slightly increased, showing that the overall pattern of these patients has changed towards the milder cases, despite the increase in numbers. Finally, we also found there was no major changes in the etiology, which has remained the same.