Use of Autologous Serum Tears for the Treatment of Ocular Surface Disease From Patients With Systemic Autoimmune Diseases

• Published in: American journal of ophthalmology Vol. 189; pp. 65 - 70
• Main Authors: Ali, Tayyeba K., Gibbons, Allister, Cartes, Cristián, Zarei-Ghanavati, Siamak, Gomaa, Mohamed, Gonzalez, Ingrid, Gonzalez, Astrid E., Ozturk, Hilal E., Betancurt, Carolina, Perez, Victor L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2018; Elsevier Limited
• Subjects: Adult; Aged; Aged, 80 and over; Autoimmune diseases; Autoimmune Diseases - physiopathology; Autoimmune Diseases - therapy; Biological Therapy - methods; Cornea; Corneal Diseases - physiopathology; Corneal Diseases - therapy; Dry Eye Syndromes - physiopathology; Dry Eye Syndromes - therapy; Female; Follow-Up Studies; Glucocorticoids - therapeutic use; Humans; Immunosuppressive Agents - therapeutic use; Male; Middle Aged; Ophthalmic Solutions; Ophthalmology; Patients; Retrospective Studies; Serum - physiology; Visual Acuity - physiology; United States > US
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2018.02.009

To describe the safety and efficacy of autologous serum tears (AST) in managing ocular surface disease resistant to conventional therapy in patients with systemic autoimmune disease(s). Retrospective, interventional case series. Records of patients from 2009 to 2015 with systemic autoimmune disease treated with AST (20%–50%) for chronic surface disease were analyzed. Standardized measures of subjective dry eye symptoms, objective dry eye staining of the cornea, and slit-lamp findings including punctate epithelial erosion (PEE), filamentary keratopathy (FK), and corneal epithelial defects (KED) were compared during first and last visit. We attempted to standardize outcomes by creating a scale from 1 to 4 for subjective and objective components: worsening (1), no improvement (2), partial improvement (3), and complete resolution (4). Fifty-one patients (101 eyes) were included. The mean age was 59.8 ± 13.2 years (72.5% female). Average use of AST was 14.3 ± 11.7 months. Complete objective improvement of initial slit-lamp findings was achieved in 30% and partial improvement in 55% of eyes. Presence of PEE, FK, and KED decreased from 92.1% to 52.5% (P < .001), from 22.8% to 9.9% (P = .02), and from 5% to 2% (P = .44) of the eyes, respectively. Full subjective improvement of symptoms was achieved in 34.6%, partial in 50.5%, and none in 14.9% of patients. No adverse side effects were noted during follow-up. AST are a safe and effective adjunct therapy in improving both objective signs and subjective symptoms of ocular surface disorders associated with systemic autoimmune disease(s).