Effects of topical autologous serum on the ocular surface in patients with toxic corneal epitheliopathy induced by anti-glaucoma drugs

Abstract

PurposeTo investigate the effects of topical autologous serum application on the ocular surface in patients with toxic corneal epitheliopathy induced by anti-glaucoma drugs.MethodsThe patients who had corneal epitheliopathy because of preservative-containing anti-glaucoma eye drops were prospectively enrolled. The epitheliopathy was refractory to preservative-free artificial tear treatment. The patients topically applied 20% autologous serum to the eye eight times per day for 1 month. Baseline and one-month change in symptoms and signs were assessed by the Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TFBUT), Schirmer I values, corneoconjunctival staining scores, corneal sensitivity, InflammaDry((R)) tear immunoassay, and tear cytokine profiles using a bead-based multiplex assay.ResultsA total of ten consecutive patients were enrolled between January and August 2018 and evaluated after one-month treatment with 20% autologous serum eye drops. Significant improvement was observed in symptoms (OSDI scores from 25.520.9 to 10.512.0; P=.039), TFBUT (from 3.1 +/- 1.8 s to 5.4 +/- 2.3 s; P=.025), corneoconjunctival staining scores (from 7.7 +/- 1.8 to 1.8 +/- 1.9 NEI scale; P=.005), corneal sensitivity (from 4.6 +/-.9 cm to 5.8 +/-.5 cm; P=.013), and metalloproteinase-9 levels (P=.013). There were no significant changes in Schirmer I values and tear cytokine levels on multiplex assays. Treatment-related side effects were not detected.Conclusions Topical instillation of 20% autologous serum is an effective treatment for toxic corneal epitheliopathy associated with anti-glaucoma eye drops.Trial registration number KCT0003827.