Preliminary evidence of neuropeptides involvement in keratoconus

Keratoconus is the most commoncorneal dystrophy that leads to severe visual impairment. Although the major etiologicalfactors are genetic, the pathogenetic mechanism(s) is unknown. Previous studies demonstrated an increased apoptosis of corneal cells, a decreased corneal sensitivity, anatomic corneal nerve changes and a progression of the disease after trigeminal nerveinjury, suggesting a pathogenic role of corneal sensorial innervation in keratoconus development and progression. Cornealnerves release several neuromediators, including substance P (SP), calcitonin-gene-related peptide (CGRP) and vasoactive intestinal peptide (VIP) that modulate corneal trophism, healing and inflammation.