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Topical Insulin for Ocular Surface Disease.
Pau Cid-Bertomeu1, Magí Vilaltella1,2, Mireia Martínez3
1Department of Ophthalmology, University Hospital Arnau de Vilanova, Lleida, Spain.
Summary
Topical insulin shows promise for treating corneal epithelial defects by aiding nerve regeneration. However, its effectiveness for dry eye disease requires further investigation, and more data is needed on safety and optimal dosing for ocular use.
Area of Science:
- Ophthalmology
- Endocrinology
- Regenerative Medicine
Background:
- Insulin and insulin-like growth factor (IGF)-1 receptors are found in ocular tissues, including the cornea and conjunctiva.
- Insulin is vital for corneal epithelial cell growth, differentiation, proliferation, and tissue wound healing.
Purpose of the Study:
- To review the potential of topical insulin in treating ocular surface diseases.
- To examine insulin's effects on corneal nerve regeneration and its use in conditions like dry eye and diabetic keratopathy.
Main Methods:
- Analysis of studies from the past decade on topical insulin for ocular surface diseases.
- Focus on indications, preparation, side effects, efficacy, concentrations, and dosages.
Main Results:
- Off-label topical insulin shows promise for refractory corneal epithelial defects.
- Efficacy in dry eye disease is not yet established; variations in insulin concentrations and dosing exist.
- Limited data on ocular penetration, toxicity, and systemic effects hinder widespread use.
Conclusions:
- Topical insulin has potential for treating ocular surface and corneal diseases, particularly epithelial defects.
- Further research is needed to establish clear guidelines, safety profiles, and efficacy for various conditions like dry eye disease.
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