Autologous Serum Eye Drops Safe, Effective for Dry Eyes

Laurie Barclay, MD

December 18, 2014

Autologous serum (AS) 50% eye drops appear to be safe and effective for dry eye disease in the long term, especially in patients with severe disease refractory to conventional treatment, according to findings of a retrospective cohort study published in the December issue of Cornea.

"Standard treatments for dry eye disease include the use of artificial tears and lubricating ointments, topical cyclosporine 0.05%, topical corticosteroids, and punctal occlusion," write Munira Hussain, MS, CCRP, from the Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, and colleagues. "However, none of these treatments supply epithelium-promoting growth factors or other essential components present in natural tears. Similar to tears, human serum contains immunoglobulins, vitamin A, fibronectin, and growth factors that promote epithelial health."

In the current study, the authors examined the outcomes of long-term use of 50% AS eye drops in patients treated at the study authors' institution between June 2008 and January 2013, using medical record review and ocular surface evaluation. This included Schirmer testing with topical anesthesia, fluorescein staining, and ocular surface disease index examined at baseline, 1 month, and every 3 to 6 months during AS treatment.

A total of 63 patients (123 eyes) enrolled in the study and had a mean follow-up of 12 months (range, 3 - 48 months). All outcomes improved significantly at various points, with no reported complications.

Corneal fluorescein staining improved from 1.77 ± 1.1 at baseline to 1.2 ± 1.0 at 3 to less than 6 months (P = .003), 1.3 ± 1.0 at 6 to less than 12 months (P = .017), and 1.1 ± 1.1 at final follow-up (P = .0003).

Schirmer scores improved from 6.6 ± 6.5 mm at baseline to 10.7 ± 11.4 at 12- to 24-month follow-up (P = .03). Ocular surface disease index scores improved from 54.1 ± 22.3 at baseline to 49.5 ± 8.2 at 3 to less than 6 months (P = .029), and to 39.3 ± 21.4 at 6 to less than 12 months (P = .003).

"[W]e conclude that 50% AS eye drops seem to be safe and effective for long-term treatment of dry eye disease," the study authors write. "They are a valuable option in patients with severe dry disease who have exhausted conventional forms of treatment."

Dry eye disease, caused by decreased tear production, excessive tear evaporation, and/or a tear film mucin deficiency, affects nearly 5 million Americans aged 50 years and older and is more common in women.

The authors note several study limitations including its retrospective, observational design; lack of a control group; and concomitant use of other treatments.

The authors have disclosed no relevant financial relationships.

Cornea. 2014;33:1245-1251. Full text

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