Main Article Content

Ayman G. Elnahry
Gehad A. Elnahry


cranial neuropathy, drug-induced ocular adverse event, neurotrophic keratopathy, rosuvastatin, trigeminal neuropathy


Rosuvastatin is a 3-hydroxy-3-methyl-glutaryl-CoA reductase enzyme inhibitor that is in wide use with few reported ocular adverse events.
To report a case of bilateral neurotrophic keratopathy associated with rosuvastatin therapy that dramatically improved following drug discontinuation.
Case presentation
A 65-year-old female presented with painless diminution of vision in both eyes of gradual onset and progressive course for 1 month. She had recently started rosuvastatin therapy for hyperlipidemia. Examination revealed bilateral stage 2 neurotrophic keratopathy with impaired corneal sensation which was previously resistant to conservative ulcer treatment. Following discontinuation of rosuvastatin therapy, there was dramatic bilateral improvement in corneal sensation, size of the corneal ulcers, and visual acuity.
Rosuvastatin may result in reversible trigeminal nerve impairment and neurotrophic keratopathy.
Abstract 778 | pdf Downloads 319 HTML Downloads 37 xml Downloads 22


1. Huynh T, Lecca P, Montigny M, et al. Ten-year statin adherence in survivors of ST-segment elevation myocardial infarction: Insights from the AMI-Quebec Study. J Popul Ther Clin Pharmacol 2018;25(2):e63–77.
2. Thompson PD, Clarkson P, Karas RH. Statin-associated myopathy. JAMA 2003;289:1681–90.
3. Fraunfelder FW, Richards AB. Diplopia, blepharoptosis, and ophthalmoplegia and 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitor use. Ophthalmology 2008;115:2282–5.
4. Ertas FS, Ertas NM, Gulec S, et al. Unrecognized side effect of statin treatment: Unilateral blepharoptosis. Ophthal Plast Reconstr Surg 2006;22:222–4.
5. Finsterer J, Zuntner G. Rhabdomyolysis from simvastatin triggered by infection and muscle exertion. South Med J 2005;98:827–9.
6. Gaist D, Jeppesen U, Andersen M, et al. Statins and risk of polyneuropathy: A case-control study. Neurology 2002;58;1333–7.
7. Phan T, McLeod JG, Pollard JD, et al. Peripheral neuropathy associated with simvastatin. J Neurol Neurosurg Psychiatry 1998;158:625–8.
8. Bonini S, Rama P, Olzi D, Lambiase A. Neurotrophic keratitis. Eye (Lond). 2003;17:989–95.
9. Mackie IA. Neuroparalytic keratitis. In: Fraunfelder F, Roy FH, Meyer SM, eds. Current Ocular Therapy. Philadelphia, PA: WB Saunders; 1995:452–4.
10. Elnahry AG, Abdel-Kader AA, Raafat KA, Elrakhawy K. Evaluation of the effect of repeated intravitreal bevacizumab injections on the macular microvasculature of a diabetic patient using optical coherence tomography angiography. Case Rep Ophthalmol Med 2019;2019:3936168.
11. Shi XQ, Lim TKY, Lee S, et al. Statins alleviate experimental nerve injury-induced neuropathic pain. Pain 2011;152;1033–43.
12. März P, Otten U, Miserez AR: Statins induce differentiation and cell death in neurons and astroglia. Glia 55:1–12, 2007.
13. Murinson BB, Haughey NJ, Maragakis NJ. Selected statins produce rapid spinal motor neuron loss in vitro. BMC Musculoskelet Disord 2012;13:100.
14. Negevesky GJ, Kolsky MP, Laureno R, Yau TH. Reversible atorvastatin-associated external ophthalmoplegia, anti-acetylcholine receptor antibodies, and ataxia. Arch Ophthalmol 2000;118:427–8.