Abstract
Background
To evaluate the efficacy of autologous serum (AS) eye drops for the symptomatic relief of severe dry eye syndrome (DES), as compared to conventional preservative-free artificial tears (PFAT).
Methods
This prospective double-blind randomized crossover study used the Ocular Surface Disease Index (OSDI), tear film break-up time (TBUT), Schirmer’s Test, and OXFORD Scale at baseline and after each of two 1-month treatment periods to measure the effect of 20 % diluted AS eye drops vs. PFAT in 20 consecutive severe DES patients that were refractory to conventional treatment.
Results
The study included 20 (18 female and two male) severe DES patients (40 eyes). Significantly higher TBUT (P < 0.001, Wilcoxon signed-rank test) and a greater decrease in OSDI score (55.18 % decrease in the AS treatment group vs. 19.50 % decrease in the PFAT treatment group) (P < 0.001, Student’s paired samples t-test) were observed in the AS treatment group after 1 month of treatment. There wasn’t a significant difference in Schirmer’s test and OXFORD conjunctival and corneal vital dying grading scores between the two treatment groups after 1 month of treatment (P > 0.05 [Mann–Whitney U test]).
Conclusions
AS eye drops were more effective than conventional eye drops for improving tear film stability and subjective comfort in patients with severe DES.
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References
Yoon KC, Im SK, Park YG, Jung YD, Yang SY, Choi J (2006) Application of umbilical cord serum eyedrops for the treatment of dry eye syndrome. Cornea 25:268–272
Bradley JC, Bradley RH, McCartney DL, Mannis MJ (2008) Serum growth factor analysis in dry eye syndrome. Clin Exp Ophthalmol 36:717–720
Poon AC, Geerling G, Dart JK, Fraenkel GE, Daniels JT (2001) Autologous serum eyedrops for dry eyes and epithelial defects: clinical and in vitro toxicity studies. Br J Ophthalmol 85:1188–1197
Ohashi Y, Ishida R, Kojima T, Goto E, Matsumoto Y, Watanabe K, Ishida N, Nakata K, Takeuchi T, Tsubota K (2003) Abnormal protein profiles in tears with dry eye syndrome. Am J Ophthalmol 136:291–299
Research in dry eye: report of the Research Subcommittee of the International Dry Eye WorkShop (2007) Ocul Surf 5:179–193
Noble BA, Loh RS, MacLennan S, Pesudovs K, Reynolds A, Bridges LR, Burr J, Stewart O, Quereshi S (2004) Comparison of autologous serum eye drops with conventional therapy in a randomised controlled crossover trial for ocular surface disease. Br J Ophthalmol 88:647–652
Lee GA, Chen SX (2008) Autologous serum in the management of recalcitrant dry eye syndrome. Clin Exp Ophthalmol 36:119–122
Fox RI, Chan R, Michelson JB, Belmont JB, Michelson PE (1984) Beneficial effect of artificial tears made with autologous serum in patients with keratoconjunctivitis sicca. Arthritis Rheum 27:459–461
Tsubota K, Goto E, Fujita H, Ono M, Inoue H, Saito I, Shimmura S (1999) Treatment of dry eye by autologous serum application in Sjogren's syndrome. Br J Ophthalmol 83:390–395
Matsumoto Y, Dogru M, Goto E, Ohashi Y, Kojima T, Ishida R, Tsubota K (2004) Autologous serum application in the treatment of neurotrophic keratopathy. Ophthalmology 111:1115–1120
Jeng BH, Dupps WJ Jr (2009) Autologous serum 50 % eyedrops in the treatment of persistent corneal epithelial defects. Cornea 28:1104–1108
del Castillo JM, de la Casa JM, Sardina RC, Fernandez RM, Feijoo JG, Gomez AC, Rodero MM, Sánchez JG (2002) Treatment of recurrent corneal erosions using autologous serum. Cornea 21:781–783
Kojima T, Ishida R, Dogru M, Goto E, Matsumoto Y, Kaido M, Tsubota K (2005) The effect of autologous serum eyedrops in the treatment of severe dry eye disease: a prospective randomized case–control study. Am J Ophthalmol 139:242–246
Tananuvat N, Daniell M, Sullivan LJ, Yi Q, McKelvie P, McCarty DJ, Taylor HR (2001) Controlled study of the use of autologous serum in dry eye patients. Cornea 20:802–806
Mertzanis P, Abetz L, Rajagopalan K, Espindle D, Chalmers R, Snyder C, Caffery B, Edrington T, Simpson T, Nelson JD, Begley C (2005) The relative burden of dry eye in patients' lives: comparisons to a U.S. normative sample. Invest Ophthalmol Vis Sci 46:46–50
Bron AJ (1997) The Doyne Lecture. Reflections on the tears. Eye 11:583–602
Behrens A, Doyle JJ, Stern L, Chuck RS, McDonnell PJ, Azar DT, Dua HS, Hom M, Karpecki PM, Laibson PR, Lemp MA, Meisler DM, Del Castillo JM, O'Brien TP, Pflugfelder SC, Rolando M, Schein OD, Seitz B, Tseng SC, van Setten G, Wilson SE, Yiu SC, Dysfunctional tear syndrome study group (2006) Dysfunctional tear syndrome: a Delphi approach to treatment recommendations. Cornea 25:900–907
Bron AJ, Evans VE, Smith JA (2003) Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea 22:640–650
Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL (2000) Reliability and validity of the ocular surface disease index. Arch Ophthalmol 118:615–621
Cristhian A, Urzua DHV, Huidobro A, Hernandez H, Alfaro J (2012) Randomized double-blind clinical trial of autologous serum versus artificial tears in dry eye syndrome. Curr Eye Res 37:684–688
Goto E, Shimmura S, Shimazaki J, Tsubota K (2001) Treatment of superior limbic keratoconjunctivitis by application of autologous serum. Cornea 20:807–810
Tsubota K, Goto E, Shimmura S, Shimazaki J (1999) Treatment of persistent corneal epithelial defect by autologous serum application. Ophthalmology 106:1984–1989
Ogawa Y, Okamoto S, Mori T, Yamada M, Mashima Y, Watanabe R, Kuwana M, Tsubota K, Ikeda Y, Oguchi Y (2003) Autologous serum eye drops for the treatment of severe dry eye in patients with chronic graft-versus-host disease. Bone Marrow Transplant 31:579–583
Geerling G, Maclennan S, Hartwig D (2004) Autologous serum eye drops for ocular surface disorders. Br J Ophthalmol 88:1467–1474
Rocha EM, Pelegrino FS, de Paiva CS, Vigorito AC, de Souza CA (2000) GVHD dry eyes treated with autologous serum tears. Bone Marrow Transplant 25:1101–1103
Kojima T, Higuchi A, Goto E, Matsumoto Y, Dogru M, Tsubota K (2008) Autologous serum eye drops for the treatment of dry eye diseases. Cornea 27:25–30
Cho YK, Huang W, Kim GY, Lim BS (2013) Comparison of autologous serum eye drops with different diluents. Curr Eye Res 38:9–17
Gupta A, Monroy D, Ji Z, Yoshino K, Huang A, Pflugfelder SC (1996) Transforming growth factor beta-1 and beta-2 in human tear fluid. Curr Eye Res 15:605–614
McDonnell PJ, Schanzlin DJ, Rao NA (1988) Immunoglobulin deposition in the cornea after application of autologous serum. Arch Ophthalmol 106:1423–1425
Sosa AB, Epstein SP, Asbell PA (2008) Evaluation of toxicity of commercial ophthalmic fluoroquinolone antibiotics as assessed on immortalized corneal and conjunctival epithelial cells. Cornea 27:930–934
Lin CP, Boehnke M (2000) Effect of fortified antibiotic solutions on corneal epithelial wound healing. Cornea 19:204–206
Quinto GG, Campos M, Behrens A (2008) Autologous serum for ocular surface diseases. Arq Bras Oftalmol 71:47–54
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Celebi, A.R.C., Ulusoy, C. & Mirza, G.E. The efficacy of autologous serum eye drops for severe dry eye syndrome: a randomized double-blind crossover study. Graefes Arch Clin Exp Ophthalmol 252, 619–626 (2014). https://doi.org/10.1007/s00417-014-2599-1
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DOI: https://doi.org/10.1007/s00417-014-2599-1