Department of Health Promotion Center, College of Medicine, The Catholic University of Korea, Seoul, St. Mary's Hospital, Seoul, Korea.
J Ocul Pharmacol Ther. 2012 Oct;28(5):479-83. doi: 10.1089/jop.2012.0002. Epub 2012 Jun 25.
To evaluate the therapeutic effect of allogeneic serum eye drops for the treatment of dry eye in patients with chronic graft-versus-host disease (cGVHD) following bone marrow transplantation.
Sixteen patients with cGVHD following allogeneic hematological stem cell transplantation (allo-SCT) and diagnosed with dry eye syndrome refractory to conventional treatment were prospectively enrolled in this study. Allogeneic serum eye drops were obtained from healthy related donors after serologic testing. Symptom scores, tear breakup time (tBUT), the Schirmer test without anesthesia (Schirmer I test), tear osmolarity, corneal staining score, impression cytology grade, and goblet cell densities were evaluated before and 4 weeks after administration of allogeneic serum eye drops.
Enrolled patients included 6 females and 10 males between 20 and 61 years of age (mean age, 37.2±11.6 years). After 4 weeks of treatment, the Ocular Surface Disease Index (OSDI) symptom scores decreased significantly (32.5-8.9). Tear osmolarity showed a significant decrease from 311.1 to 285.1 milliosmol. The corneal staining scores significantly decreased from 2.5 to 1.8. Impression cytology grade and goblet cell density improved from 3.4 to 2.4 and from 90.6 to 122.6 cell/mm(2), respectively. tBUT also significantly improved from 2.9 to 4.4 s, and the Schirmer I test results showed improvement, but lacked statistical significance (1.7-2.4 mm). No significant side effects were detected as a result of the allogeneic serum treatment during the follow-up period.
Allogeneic serum can be used for the treatment of severe dry eye in patients with cGVHD when autologous serum is unavailable. Care should be taken to avoid the risk of blood-borne diseases.
评估异体血清滴眼液治疗异基因造血干细胞移植（allo-SCT）后慢性移植物抗宿主病（cGVHD）患者干眼症的疗效。
前瞻性纳入 16 例 allo-SCT 后发生 cGVHD 且常规治疗无效的干眼症患者。经血清学检测后，采集健康供者的异体血清制作成滴眼液。在使用异体血清滴眼液前和使用后 4 周，分别评估患者的症状评分、泪膜破裂时间（tBUT）、非麻醉状态下的泪液分泌试验（Schirmer I 试验）、泪液渗透压、角膜染色评分、印迹细胞学检查分级和杯状细胞密度。
入组患者为 6 例女性和 10 例男性，年龄 20～61 岁，平均（37.2±11.6）岁。治疗 4 周后，眼表疾病指数（OSDI）症状评分由（32.5±8.9）分显著降低，泪液渗透压由 311.1 毫渗摩尔/升降至 285.1 毫渗摩尔/升，角膜染色评分由 2.5 分降至 1.8 分，印迹细胞学检查分级和杯状细胞密度分别由 3.4 分和 90.6 个/平方毫米改善至 2.4 分和 122.6 个/平方毫米，tBUT 由 2.9 秒延长至 4.4 秒，Schirmer I 试验结果改善但差异无统计学意义（1.7～2.4 毫米）。随访期间，患者未出现与异体血清治疗相关的不良反应。
在自身血清无法获得的情况下，异体血清可用于治疗 cGVHD 患者的严重干眼症，但应注意避免血源性疾病的风险。
