Drops Derived From Donor Blood Ease Symptoms in Severe Dry Eye

By Anne Harding

December 13, 2019

NEW YORK (Reuters Health) - Allogeneic blood-derived eyedrops improve signs and symptoms of severe dry-eye disease (DED), a new randomized controlled trial shows.

Patients treated with eyedrops derived from cord blood or from healthy adult donor blood each showed improvements in objective and subjective measurements of disease severity, with a suggestion of better outcomes with cord blood.

"Our findings demonstrated the efficacy of eye drops derived from blood taken from donors (allogeneic) and administered to severe DED patients (such as Sjogren's-syndrome sufferers or graft-versus-host disease after haematological diseases and haematopoietic cell transplants)," said Dr. Piera Versura of the University of Bologna in Italy.

"The cord-blood derived eyedrops could be dedicated for highly selected patients, so the reduced availability in principle could be enough for dispensation," she told Reuters Health by email.

Eyedrops made from a patient's own peripheral blood (autologous serum, AS) are the most widely used blood-derived treatment in DED, Dr. Versura and her team note in the British Journal of Ophthalmology.

"The rationale for the use of products prepared from blood as a source and delivered as eye drops relies upon their content of substances mimicking the natural tears such as growth factors, vitamins and nutrients," the author explained.

"Not all patients are good candidates as donors, even for themselves, due to underlying systemic inflammatory diseases, age, drug catabolites, or other types of comorbidities," she added.

To investigate allogeneic options, Dr. Versura and her colleagues randomly assigned 60 patients with severe DED and persistent corneal epithelial defects to receive eyedrops derived from cord-blood serum (CBS) or from healthy adults' peripheral-blood serum (PBS).

Patients used the drops eight times a day for a month, with two additional months of follow-up. Those who had a relapse in signs or symptoms were switched to the other treatment for an additional month.

Fifty-three of the 60 treated eyes (88.3%) showed a significant improvement in corneal staining, and three of these eyes had complete resolution of corneal damage.

Nineteen eyes (31%) had relapsed or worsening epithelial defects after the follow-up period, including eight from the CBS group and 11 from the PBS group.

Reduction in corneal staining was greater in the CBS group than the PBS group. Both groups had similar reductions in visual analog score (VAS) and ocular disease severity index (OSDI).

The amount of reduction in corneal damage was directly related to concentrations of several growth factors.

"Eyedrops prepared from blood are important treatments for severe DED and ocular-surface diseases in general, and in the future maybe beyond," Dr. Versura said. "A strict collaboration among different disciplines should be established with the aim to optimize preparation, select specific content, and stratify patients for successful clinical outcomes."

The study did not have commercial funding, and the authors declare no conflicts of interest.

SOURCE: https://bit.ly/2sZNWH9 British Journal of Ophthalmology, online November 19, 2019.