APR 01, 2015
By Jennifer Li, MD
Cornea/External Disease
This small study shows that oral nicergoline can help facilitate healing in patients with neurotrophic keratopathy. Although not FDA approved, this research shows nicergoline has potential as an adjunctive therapy for our more difficult to manage cases.
Subjects included 24 patients (27 eyes), unresponsive to conventional therapy, who were treated with 10 mg of oral nicergoline twice daily for at least 2 weeks. Epithelial defects healed completely in 23 eyes (85%). On average, it took 15.6 days for patients to heal. Treated subjects experienced significant improvement in corneal sensitivity and best-corrected visual acuity (both, P< 0.001), and they showed higher levels of tear nerve growth factor (NGF), ranging from 3.2±0.3 to 6.2±0.3 pg/mL (P< 0.001).
Nicergoline is an ergoline derivative used to treat cognitive impairment due to degenerative dementia or following stroke. In previous studies it demonstrated an ability to accelerate corneal epithelial healing in rats. The authors postulate that nicergoline may facilitate healing of epithelial defects by increasing NGF levels or boosting acetylcholine.
Though more study is required to compare oral nicergoline to other currently available treatments, the authors note that it would be cheaper and easier to administer than direct topical NGF or autologous serum eye drops. Moreover, instead of replacing these treatments, it may be used adjunctively to strengthen the effects of NGF or autologous serum eye drops.