Resumen
Objetivo: Describir los efectos de la insulina tópica en el tratamiento de patologías corneales. Revisión bibliográfica: La insulina es una hormona proteica producida por las células beta del páncreas, que juega un papel crucial en el control glicémico y en los procesos metabólicos del cuerpo humano. Más allá de estas funciones, la insulina es esencial para la reparación tisular, ya que activa citocinas antiinflamatorias y promueve la curación de los tejidos. La córnea, una estructura ocular transparente, convexa, avascular y altamente inervada, actúa como una barrera protectora contra lesiones y agentes infecciosos, desempeñando un papel vital en la protección de las estructuras internas del ojo. En el tratamiento de patologías corneales, la insulina tópica ha demostrado ser efectiva en la reepitelización de defectos epiteliales persistentes, reduciendo la necesidad de intervenciones quirúrgicas. Por lo tanto, la insulina tópica puede mejorar la recuperación de la córnea y minimizar las complicaciones asociadas con los tratamientos tradicionales. Consideraciones finales: La insulina tópica ha demostrado ser efectiva en el tratamiento de patologías corneales, ofreciendo buena disponibilidad, bajo costo y excelente tolerancia.
Referencias
BHUIYAN ZA, et al. Localised insulin administration for wound healing in non-diabetic adults: A systematic review and meta-analysis of randomised controlled trials. Wound Repair and Regeneration: The International Journal of Tissue Repair and Regeneration, 2023; 31: 516-527.
CHEN S, et al. Insulin eye drops improve corneal wound healing in STZ-induced diabetic mice by regulating corneal inflammation and neuropeptide release. BMC Ophthalmology, 2024; 24(1): 1-10.
DANG DH, et al. Treatment of non-infectious corneal injury: Review of diagnostic agents, therapeutic medications, and future targets. Drugs, 2022; 82(2): 145-167.
DIAZ VD, et al. Comparison of the efficacy of topical insulin with autologous serum eye drops in persistent epithelial defects of the cornea. Acta Ophthalmologica, 2022; 100(4): 1-10.
DIAZ VD, et al. Topical insulin for refractory persistent corneal epithelial defects. European Journal of Ophthalmology, 2021; 31(5): 2280-2286.
FAI S, et al. Randomized controlled trial of topical insulin for healing corneal epithelial defects induced during vitreoretinal surgery in diabetics. Asia-Pacific Journal of Ophthalmology, 2017; 6(5): 418-424.
GUPTA Y, et al. Peripheral ulcerative keratitis. Survey of ophthalmology, 2021; 66(6): 977–998.
IKER ETCHEGARAY J, et al. Phagocytosis in the retina promotes local insulin production in the eye. Nature metabolism, 2023; 5: 207–218.
HASSANPOUR K, et al. Peripheral ulcerative keratitis: A review. Journal of Ophthalmic & Vision Research, 2022; 17: 252-275.
HOFFMAN JJ, et al. Management of filamentous fungal keratitis: A pragmatic approach. Journal of fungi (Basel, Switzerland), 2022; 8 (10): 1067.
HRYNYK M e NEUFELD RJ. Insulina e cicatrização de feridas. Burns: Journal of the International Society for Burn Injuries, 2014; 40(8): 1433-1446.
JAWORSKI M, et al. Topical insulin in neurotrophic keratopathy: A review of current understanding of the mechanism of action and therapeutic approach. Pharmaceutics, 2023; 16(1): 1-10.
LIN SR, et al. Recurrent corneal erosion syndrome. The British journal of ophthalmology, 2019; 103(9): 1204–1208.
MILLER DD, et al. Recurrent corneal erosion: A comprehensive review. Clinical Ophthalmology, 2019; 13: 325-335.
MOHAN RR, et al. Corneal stromal repair and regeneration. Progress in Retinal and Eye Research, 2022; 91: 101090.
NAPOLITANO, et al. Insulin resistance and skin diseases. The Scientific World Journal, 2015: 479354.
NANAVATY M. Treating corneal perforation related to neurotrophic keratitis. Acta ophthalmologica, 2024; 102: S279.
SRIDHAR MS, et al. Anatomy of cornea and ocular surface. Indian Journal of Ophthalmology, 2018; 66: 190.
STUARD WL,et al. O eixo IGF/insulina-IGFBP no desenvolvimento da córnea, cicatrização de feridas e doenças. Frontiers in Endocrinology, 2020; 11: 1-10.
VICARIO DLTM, et al. Topical insulin eye drops: Stability and safety of two compounded formulations for treating persistent corneal epithelial defects. Pharmaceutics, 2024; 16(5): 580.
VOSS K, et al. Non-infectious and non-hereditary diseases of the corneal epithelium. Experimental Eye Research, 2021; 202: 108316.
WANG AL, et al. Use of topical insulin to treat refractory neurotrophic corneal ulcers. Cornea, 2017; 36: 1426–1428.
WILSON SE, et al. Corneal wound healing. Experimental Eye Research, 2020; 197: 108089.
XIMENES KF, et al. The role of Descemet’s membrane in the pathogeny of corneal edema following anterior segment surgery. Revista brasileira de oftalmologia, 2014; 73: 262–268.
YANG P, et al. Aplicação tópica de insulina acelera a cicatrização de feridas diabéticas promovendo polarização anti-inflamatória de macrófagos. Journal of Cell Science, 2020; 133(19): 235838.
