The Application of the Autologous Serum Eye Drops Results in Significant Improvement of the Conjunctival Status in Patients with the Dry Eye Syndrome
Authors:
K. Jirsová 1,2; E. Hrdličková 1,3; A. Alfakih 1,2,3; K. Juklová 1; M. Filipec 1,4; V. Faltus 5; V. Veselá 1,2
Authors place of work:
Laboratoř biologie a patologie oka, Ústav dědičných metabolických poruch VFN a 1. LF UK, Praha, vedoucí prof. MUDr. Milan Elleder, DrSc.
1; Oční tkáňová banka VFN a 1. LF UK, Praha, vedoucí MUDr. Marcela Černická, MBA
2; Oční klinika VFN a 1. LF UK, Praha, vedoucí doc. MUDr. Bohdana Kalvodová, CSc.
3; Oční klinika Lexum, Praha, vedoucí prof. MUDr. Martin Filipec, CSc.
4; EuroMISE centrum, Ústav informatiky AV ČR v. v. i., Praha, vedoucí prof. RNDr. Jana Zvárová, DrSc.
5
Published in the journal:
Čes. a slov. Oftal., 64, 2008, No. 2, p. 52-56
Summary
Aim:
To detect the changes on the conjunctiva surface before and after the application of the autologous serum (AS) eye drops in patients with dry eye syndrome, using both clinical and laboratory approaches, supplemented with subjective assessing the discomfort status.
Materials and methods:
The AS eye drops were applied during the period of 3 months in 8 patients with dry eye syndrome (Schirmer test < 5 mm and break-up time < 5 seconds), with the highest (maximum) frequency 8 times a day. The clinical (Schirmer test, break-up time, rose Bengal staining, examination of the tear meniscus, detritus and superficial punctate keratitis) and laboratory examinations (morphological assessment of the conjunctiva, detection of apoptotic cells) were performed at the start and at the end of the 3 months treatment period. Each day, patients reported their ocular status (dryness, discomfort, foreign body sensation, light sensitivity).
Results:
The AS eye drops application improved significantly the values of the Schirmer test, detritus and superficial punctate keratitis as well. The goblet cells density on the conjunctival surface increased and the number of apoptotic cells decreased. The intensity of unpleasant feelings reported by the patients decreased significantly in all of the assessed categories.
Conclusion:
Because the application of AS eye drops caused the improvement of conjunctival status as well as the decrease of the severity of difficulties reported by the patients, the AS eye drops application should become common therapeutic practice in patients with dry eye syndrome.
Key words:
dry eye syndrome, autologous serum eye drops, conjunctiva
Zdroje
1. Brignole, F., De Saint-Jean, M., Goldschild, M. et al.: Expression of Fas-Fas ligand antigens and apoptotic marker APO2.7 by the human conjunctival epithelium. Positive correlation with class II HLA DR expression in inflammatory ocular surface disorders. Exp Eye Res., 67, 1998, 6: 687–697.
2. Brignole, F., Pisella, P.J., Goldschild, M., et al.: Flow cytometric analysis of inflammatory markers in conjunctival epithelial cells of patients with dry eyes. Invest Ophthalmol Vis Sci., 41,2000, 6: 1356–1363.
3. del Castillo, J.M., de la Casa, J.M., Sardina, R.C. et al.: Treatment of recurrent corneal erosions using autologous serum. Cornea, 21, 2002, 8: 781–783.
4. Djalilian, A.R., Mahesh, S.P., Koch, C.A. et al.: Survival of donor epithelial cells after limbal stem cell transplantation. Invest Ophthalmol Vis Sci., 46, 2005, 3: 803–807.
5. Esquenazi, S., He, J., Bazan, H.E. et al.: Use of autologous serum in corneal epithelial defects post-lamellar surgery. Cornea, 24, 2005, 8: 992–997.
6. Fox, R.I., Chan, R., Michelson, J.B. et al.: Beneficial effect of artificial tears made with autologous serum in patients with keratoconjunctivitis sicca. Arthritis Rheum., 27, 1984, 4: 459–461.
7. Gavrieli, Y., Sherman, Y.Ben-Sasson, S.A.: Identification of programmed cell death in situ via specific labeling of nuclear DNA fragmentation. J Cell Biol., 119, 1992, 3: 493–500.
8. Geerling, G., Maclennan, S.Hartwig, D.: Autologous serum eye drops for ocular surface disorders. Br J Ophthalmol., 88, 2004, 11: 1467–1474.
9. Gobbels, M.Spitznas, M.: Corneal epithelial permeability of dry eyes before and after treatment with artificial tears. Ophthalmology, 99, 1992, 6: 873–878.
10. Goto, E., Shimmura, S., Shimazaki, J. et al.: Treatment of superior limbic keratoconjunctivitis by application of autologous serum. Cornea, 20, 2001, 8: 807–810.
11. Hori, Y., Spurr-Michaud, S., Russo, C.L. et al.: Differential regulation of membrane-associated mucins in the human ocular surface epithelium. Invest Ophthalmol Vis Sci., 45, 2004, 1: 114–122.
12. Jirsova, K., Juklova, K., Vesela, V. et al.: Morphological and immunocytochemical characterization of snake-like chromatin cells. Histol Histopathol., 21, 2006, 4: 355–360.
13. Kojima, T., Ishida, R., Dogru, M. et al.: The effect of autologous serum eyedrops in the treatment of severe dry eye disease: a prospective randomized case-control study. Am J Ophthalmol., 139, 2005, 2: 242–246.
14. Matsumoto, Y., Dogru, M., Goto, E. et al.: Autologous serum application in the treatment of neurotrophic keratopathy. Ophthalmology 111,2004, 6: 1115–1120.
15. Matsuo, H., Tomidokoro, A., Tomita, G. et al.: Topical application of autologous serum for the treatment of late-onset aqueous oozing or point-leak through filtering bleb. Eye 19,2005, 1: 23–28.
16. McDonnell, P.J., Schanzlin, D.J.Rao, N.A.: Immunoglobulin deposition in the cornea after application of autologous serum. Arch Ophthalmol 106,1988, 10: 1423–1425.
17. Mishima, H., Nakamura, M., Murakami, J. et al.: Transforming growth factor-beta modulates effects of epidermal growth factor on corneal epithelial cells. Curr Eye Res 11,1992, 7: 691–696.
18. Nelson, J.D.: Diagnosis of keratoconjunctivitis sicca. Int Ophthalmol Clin 34,1994, 1: 37–56.
19. Nelson, J.D.Farris, R.L.: Sodium hyaluronate and polyvinyl alcohol artificial tear preparations. A comparison in patients with keratoconjunctivitis sicca. Arch Ophthalmol 106,1988, 4: 484–487.
20. Nelson, J.D., Havener, V.R.Cameron, J.D.: Cellulose acetate impressions of the ocular surface. Dry eye states. Arch Ophthalmol 101,1983, 12: 1869–1872.
21. Nishida, T., Ohashi, Y., Awata, T. et al.: Fibronectin. A new therapy for corneal trophic ulcer. Arch Ophthalmol 101,1983, 7: 1046–1048.
22. Noble, B.A., Loh, R.S., MacLennan, S. et al.: Comparison of autologous serum eye drops with conventional therapy in a randomised controlled crossover trial for ocular surface disease. Br J Ophthalmol., 88, 2004, 5: 647–652.
23. Ogawa, Y., Okamoto, S., Mori, T. et al.: Autologous serum eye drops for the treatment of severe dry eye in patients with chronic graft-versus-host disease. Bone Marrow Transplant., 31, 2003, 7: 579–583.
24. Ohashi, Y., Motokura, M., Kinoshita, Y. et al.: Presence of epidermal growth factor in human tears. Invest Ophthalmol Vis Sci., 30, 1989, 8: 1879–1882.
25. Perry, H.D.Donnenfeld, E.D.: Dry eye diagnosis and management in 2004. Curr Opin Ophthalmol., 15, 2004, 4: 299–304.
26. Pflugfelder, S.C., Solomon, A.Stern, M.E.: The diagnosis and management of dry eye: a twenty-five-year review. Cornea, 19,2000, 5: 644–649.
27. Poon, A.C., Geerling, G., Dart, J.K. et al.: Autologous serum eyedrops for dry eyes and epithelial defects: clinical and in vitro toxicity studies. Br J Ophthalmol., 85, 2001, 10: 1188–1197.
28. Rivas, L., Oroza, M.A., Perez-Esteban, A. et al.: Morphological changes in ocular surface in dry eyes and other disorders by impression cytology. Graefes Arch Clin Exp Ophthalmol 230,1992, 4: 329–334.
29. Shimmura, S., Ueno, R., Matsumoto, Y. et al.: Albumin as a tear supplement in the treatment of severe dry eye. Br J Ophthalmol., 87,2003, 10: 1279–1283.
30. Tananuvat, N., Daniell, M., Sullivan, L.J. et al.: Controlled study of the use of autologous serum in dry eye patients. Cornea, 20, 2001, 8: 802–806.
31. Tseng, S.C.: Staging of conjunctival squamous metaplasia by impression cytology. Ophthalmology, 92, 1985, 6: 728–733.
32. Tseng, S.C.: Topical tretinoin treatment for dry-eye disorders. Int Ophthalmol Clin., 27, 1987, 1: 47–53.
33. Tseng, S.C., Maumenee, A.E., Stark, W.J., et al.: Topical retinoid treatment for various dry-eye disorders. Ophthalmology, 92, 1985, 6: 717–727.
34. Tsubota, K., Goto, E., Fujita, H., et al.: Treatment of dry eye by autologous serum application in Sjogren’s syndrome. Br J Ophthalmol., 83, 1999, 4: 390–395.
35. Tsubota, K., Goto, E., Shimmura, S., et al.: Treatment of persistent corneal epithelial defect by autologous serum application. Ophthalmology, 106, 1999, 10: 1984–1989.
36. van Setten, G.B., Viinikka, L., Tervo, T., et al.: Epidermal growth factor is a constant component of normal human tear fluid. Graefes Arch Clin Exp Ophthalmol., 227, 1989, 2: 184–187.
37. Young, A.L., Cheng, A.C., Ng, H.K., et al.: The use of autologous serum tears in persistent corneal epithelial defects. Eye, 18, 2004, 6: 609–614.
Štítky
OphthalmologyČlánok vyšiel v časopise
Czech and Slovak Ophthalmology
2008 Číslo 2
Najčítanejšie v tomto čísle
- The Application of the Autologous Serum Eye Drops Results in Significant Improvement of the Conjunctival Status in Patients with the Dry Eye Syndrome
- Treatment for Recurrent Pterygium
- Spontaneous Premacular Hemorrhage
- Applying the DNA Diagnostics in Patients with Superficial Keratitis of Viral Origin